Individual
MR. TIMOTHY RAYMOND VANCLEVE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
214 S CITIES SERVICE HWY, SULPHUR, LA 70663-6404
(337) 625-4077
(337) 625-5938
Mailing address
214 S CITIES SERVICE HWY, SULPHUR, LA 70663-6404
(337) 625-4077
(337) 625-5938
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
895
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5167439
AETNA
LA
Enumeration date
03/21/2006
Last updated
07/08/2007
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