Organization
FAIRCLOTH CHIROPRACTIC CLINIC, L.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KELLY BOISVERT FAIRCLOTH DC (CHIROPRACTOR/OWNER)
(318) 448-8462
Entity
Organization
Contact information
Practice address
3620 BAYOU RAPIDES RD, ALEXANDRIA, LA 71303-3653
(318) 448-8462
(318) 448-8486
Mailing address
3620 BAYOU RAPIDES RD, ALEXANDRIA, LA 71303-3653
(318) 448-8462
(318) 448-8486
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
915
LA
Other
Enumeration date
10/28/2008
Last updated
11/06/2008
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