Organization

Mississippi Upper Cervical Clinic, Inc

Chiropractor in Southaven, MS(View on Map)

Legal Business Name

Mississippi Upper Cervical Clinic, Inc

NPI Number

1346318797

NPI Type

Organization

Enumeration Date

12/02/2006

Specialties

(Taxonomies)

Code

111N00000X

Primary Taxonomy

Yes

Licenses

State

Mississippi

License Number

1100

Contact
Information

Purpose

Mailing
Location

Address

7651 TCHULAHOMA RD
7651 TCHULAHOMA RD

City

Southaven
Southaven

State

MS
MS

Postal Code

38671
38671-9227

Country

US
US

Telephone Number

(662) 349-0980
(662) 349-0980

Authorized Official

Name

Dr. Trevor Qualls

Title or Position

CHIROPRACTOR

Telephone Number

(662) 349-0980

Identifiers

Identifier

415350960

Identifier State

MS

Identifier Issuer

BCBS

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 03/20/2008

Provider Address

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