Organization
GREAT SOUTH MANAGEMENT LLC
Active
Other names
DeRidder Chiropractic
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN ROBERT JOHNSON D.C. (CHIROPRACTOR)
(337) 462-3055
Entity
Organization
Contact information
Practice address
1606 N PINE ST, DERIDDER, LA 70634-2420
(337) 462-3055
(337) 462-0741
Mailing address
1606 N PINE ST, DERIDDER, LA 70634-2420
(337) 462-3055
(337) 462-0741
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1168
LA
Other
Enumeration date
06/29/2006
Last updated
12/11/2012
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