Individual
DR. JAY M PERNICIARO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
108 MEMORIAL DR, DONALDSONVILLE, LA 70346-4337
(225) 473-3990
(225) 473-3992
Mailing address
PO BOX 631, DONALDSONVILLE, LA 70346-0631
(225) 473-3990
(225) 473-3992
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
938
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1953342
—
LA
Enumeration date
07/14/2005
Last updated
07/08/2007
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