Healthcare Provider Details

I. General information

NPI: 1730034463
Provider Name (Legal Business Name): QUICKFIX LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/27/2026
Last Update Date: 05/20/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

311 CLINTON BLVD STE C
CLINTON MS
39056-5251
US

IV. Provider business mailing address

311 CLINTON BLVD STE C
CLINTON MS
39056-5251
US

V. Phone/Fax

Practice location:
  • Phone: 601-526-1444
  • Fax:
Mailing address:
  • Phone: 601-526-1444
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QP3300X
TaxonomyPain Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QR0800X
TaxonomyRecovery Care Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code171000000X
TaxonomyMilitary Health Care Provider
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number State

VIII. Authorized Official

Name: JAZZMEN BRISCOE
Title or Position: MASSAGE THERAPIST
Credential: LMT
Phone: 601-526-1444