Individual
NICOLLE MARIE RIVERA REYES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.C.
Contact information
Practice address
1603 BOONE ST STE C, LEESVILLE, LA 71446-5780
(337) 377-0477
(337) 404-1207
Mailing address
1603 BOONE ST STE C, LEESVILLE, LA 71446-5780
(337) 377-0477
(337) 404-1207
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1973
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1973
CHIROPRACTOR
LA
Enumeration date
01/17/2023
Last updated
01/17/2023
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