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General NPI Number Information
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NPI Number | 1679740492
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Entity Type | Organization
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Legal Business Name | D AND F INC
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Dates
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Enumeration Date | 05/12/2008
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Last Update Date | 05/12/2008
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Provider Practice Location Address
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Address Line | 4308 PARK TEN DR
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City | DIAMONDHEAD
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State | MS
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Zip | 39525-3222
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Country | US
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Telephone | 228-255-5328
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Fax | 228-255-0026
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Provider Business Mailing Address
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Address Line | 4308 PARK TEN DR
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City | DIAMONDHEAD
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State | MS
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Zip | 39525-3222
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Country | US
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Telephone | 228-255-5328
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Fax | 228-255-0026
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DESMOND W HODA
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Credential | DC
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Telephone | 228-255-5328
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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 | 887
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License Number State | MS
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