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General NPI Number Information
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NPI Number | 1164946398
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Entity Type | Individual
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Provider Name | HALEY THOMASON MCCOLLUM DC
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Gender | Female
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Dates
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Enumeration Date | 07/31/2017
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Last Update Date | 02/15/2019
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Provider Practice Location Address
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Address Line | 101 W WASHINGTON ST STE C1
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City | RIDGELAND
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State | MS
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Zip | 39157-2434
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Country | US
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Telephone | 601-856-2383
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Fax | 877-294-2560
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Provider Business Mailing Address
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Address Line | 101 W WASHINGTON ST STE C1
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City | RIDGELAND
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State | MS
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Zip | 39157-2434
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Country | US
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Telephone | 601-856-2383
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Fax | 877-294-2560
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 1276
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License Number State | MS
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