Healthcare Provider Details

I. General information

NPI: 1033420328
Provider Name (Legal Business Name): WALDROP CHIROPRACTIC AND WELLNESS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/01/2010
Last Update Date: 04/23/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

521 S MONTGOMERY ST STE 3
STARKVILLE MS
39759-3337
US

IV. Provider business mailing address

PO BOX 769
STARKVILLE MS
39760-0769
US

V. Phone/Fax

Practice location:
  • Phone: 662-546-4400
  • Fax:
Mailing address:
  • Phone: 662-418-2612
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: RACHEL WALDROP
Title or Position: OWNER
Credential: DC
Phone: 662-546-4400