Individual
ANTONIO RIVERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
2625 DILLARD LOOP, SUITE C, LAKE CHARLES, LA 70607
(318) 453-2963
Mailing address
2625 DILLARD LOOP, SUITE C, LAKE CHARLES, LA 70607
(318) 453-2963
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1836
LA
Other
Enumeration date
11/30/2018
Last updated
11/30/2018
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