Provider Demographics
NPI:1861678765
Name:JOHN L. GUILLORY, JR., D.C., LLC
Entity type:Organization
Organization Name:JOHN L. GUILLORY, JR., D.C., LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:L
Authorized Official - Last Name:GUILLORY
Authorized Official - Suffix:JR
Authorized Official - Credentials:DC
Authorized Official - Phone:337-684-5860
Mailing Address - Street 1:337 W CANAL ST
Mailing Address - Street 2:
Mailing Address - City:CHURCH POINT
Mailing Address - State:LA
Mailing Address - Zip Code:70525-3515
Mailing Address - Country:US
Mailing Address - Phone:337-684-5860
Mailing Address - Fax:337-684-5632
Practice Address - Street 1:337 W CANAL ST
Practice Address - Street 2:
Practice Address - City:CHURCH POINT
Practice Address - State:LA
Practice Address - Zip Code:70525-3515
Practice Address - Country:US
Practice Address - Phone:337-684-5860
Practice Address - Fax:337-684-5632
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-10
Last Update Date:2008-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty