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General NPI Number Information
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NPI Number | 1376882050
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Entity Type | Organization
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Legal Business Name | DESOTO COUNTY CHIROPRACTIC, INC.
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Dates
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Enumeration Date | 01/31/2013
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Last Update Date | 01/31/2013
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Provider Practice Location Address
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Address Line | 1134 CHURCH RD W
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City | SOUTHAVEN
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State | MS
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Zip | 38671-7144
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Country | US
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Telephone | 662-393-4848
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Fax | 662-393-4858
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Provider Business Mailing Address
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Address Line | PO BOX 175
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City | NESBIT
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State | MS
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Zip | 38651-0175
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Country | US
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Telephone | 662-393-4848
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Fax | 662-393-4858
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DAVID CHADWICK HALL II
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Credential | D.C.
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Telephone | 901-338-3886
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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