Provider Demographics
NPI:1255077038
Name:MATHERNE, CORTNEY LYN PRITCHARD (DC)
Entity type:Individual
Prefix:
First Name:CORTNEY
Middle Name:LYN PRITCHARD
Last Name:MATHERNE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4777 HIGHWAY 1
Mailing Address - Street 2:
Mailing Address - City:RACELAND
Mailing Address - State:LA
Mailing Address - Zip Code:70394-2626
Mailing Address - Country:US
Mailing Address - Phone:985-537-5512
Mailing Address - Fax:
Practice Address - Street 1:4777 HIGHWAY 1
Practice Address - Street 2:
Practice Address - City:RACELAND
Practice Address - State:LA
Practice Address - Zip Code:70394-2626
Practice Address - Country:US
Practice Address - Phone:985-537-5512
Practice Address - Fax:985-537-5514
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-05
Last Update Date:2024-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1953111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor