Most Relevant Information
Provider Data
| NPI Number: | 1003272808 |
| Provider Name: | JOSE CHACON |
| Entity Type: | Individual |
| Taxonomy Code: | 101Y00000X |
| Specialty: | Counselor |
| License Number: |
Most Important Dates
| Enumeration Date: | 01/08/2016 |
| Last Updated: | 01/08/2016 |
Provider Practice Location
2600 KINGSTON ST
UNIT C
KENNER
LA
700624910
Practice Location Phone/Fax
| Phone: | 5043150363 |
| Fax: |
Provider Mailing Location
2600 KINGSTON ST
UNIT C
KENNER
LA
700624910
Provider Mailing Phone/Fax
| Phone: | 5043150363 |
| Fax: |