Provider Demographics
NPI:1770605529
Name:ANDRY, DEREK JOHN (DC)
Entity type:Individual
Prefix:DR
First Name:DEREK
Middle Name:JOHN
Last Name:ANDRY
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:403 N 6TH ST STE 8-9
Mailing Address - Street 2:
Mailing Address - City:WEST MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71291-4120
Mailing Address - Country:US
Mailing Address - Phone:318-303-6142
Mailing Address - Fax:318-855-4912
Practice Address - Street 1:403 N 6TH ST STE 8-9
Practice Address - Street 2:
Practice Address - City:WEST MONROE
Practice Address - State:LA
Practice Address - Zip Code:71291-4120
Practice Address - Country:US
Practice Address - Phone:318-303-6142
Practice Address - Fax:318-855-4912
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-04
Last Update Date:2025-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA785111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor