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NPI Code Detail

MEDICARE: DODGE CHIROPRACTIC INC

MEDICARE: DODGE CHIROPRACTIC INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1111N00000XChiropractor925MS

General Provider Information

NPI Number : 1437272069
Entity Type Code : Organization
Provider Name (Legal Business Name) : DODGE CHIROPRACTIC INC
Provider Business Mailing Address
First Line : 213 HENDERSON AVE
Second Line :
City : PASS CHRISTIAN
State : MS
Zip : 39571-4309
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 213 HENDERSON AVE
Second Line :
City : PASS CHRISTIAN
State : MS
Zip : 39571-4309
Country : US
Telephone Number : 228-452-0707
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : STEVEN DODGE
Credential :
Telephone Number : 228-452-0707
Provider Enumeration Date : 04/09/2007
Last Update Date : 05/16/2012

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Directions to “DODGE CHIROPRACTIC INC ” Practice Location

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