Organization
BROADMOOR CHIROPRACTIC CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTINA MARIE RANDOLPH (OFFICE MANAGER)
(318) 868-5009
Entity
Organization
Contact information
Practice address
5805 E KINGS HWY, SHREVEPORT, LA 71105-4303
(318) 868-5009
(318) 865-4451
Mailing address
5805 E KINGS HWY, SHREVEPORT, LA 71105-4303
(318) 868-5009
(318) 865-4451
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
—
Other
Enumeration date
03/14/2007
Last updated
08/22/2020
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