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General NPI Number Information
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NPI Number | 1295529634
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Entity Type | Organization
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Legal Business Name | SOUTHERN SPINE FAMILY CHIROPRACTIC PLLC
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Dates
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Enumeration Date | 04/09/2025
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Last Update Date | 05/19/2025
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Provider Practice Location Address
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Address Line | 1896 MAIN ST STE A
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City | MADISON
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State | MS
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Zip | 39110-7676
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Country | US
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Telephone | 769-289-1114
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Fax | 769-289-1119
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Provider Business Mailing Address
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Address Line | 1896 MAIN ST STE A
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City | MADISON
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State | MS
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Zip | 39110-7676
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Country | US
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Telephone | 769-289-1114
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Fax | 769-289-1119
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Authorized Official
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Title or Position | CHIROPRACTOR
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Name | DR. HALLEY ALEXANDRA HERRERA
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Credential | DC
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Telephone | 769-289-1114
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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 |
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License Number State |
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