Individual
JACK ERROL METHVIN JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
350 METHVIN DR, PONCHATOULA, LA 70454-3629
(985) 215-7164
Mailing address
350 METHVIN DR, PONCHATOULA, LA 70454-3629
(985) 215-7164
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1908
LA
Other
Enumeration date
03/22/2023
Last updated
03/22/2023
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