Organization
SOUTHSIDE CHIROPRACTIC CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GREGORY BRIGOLA D.C. (CHIROPRACTOR)
(318) 686-3152
Entity
Organization
Contact information
Practice address
672 BERT KOUNS INDUSTRIAL LOOP, SHREVEPORT, LA 71118-5701
(318) 686-3152
Mailing address
672 BERT KOUNS INDUSTRIAL LOOP, SHREVEPORT, LA 71118-5701
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1675
LA
Other
Enumeration date
08/16/2013
Last updated
08/16/2013
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