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Individual

DR. RICKEY LYNN PREWITT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.C.

Contact information

Practice address
3121 VAN BUREN ST, SUITE B, BAKER, LA 70714-3452
(225) 774-5566
(225) 774-8855
Mailing address
3121 VAN BUREN ST, SUITE B, BAKER, LA 70714-3452
(225) 774-5566
(225) 774-8855

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
1169
AR
111N00000X
Chiropractor
608
TN
111N00000X
Chiropractor
Primary
800
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
10984758
CAQH
LA
05
1955604
LA
01
4770113
CIGNA
LA
Enumeration date
10/12/2006
Last updated
04/09/2008
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