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Organization
HWY 63 MEDICAL AND CHIROPRACTIC CENTER, P.A.
Active
Organization
HWY 63 MEDICAL AND CHIROPRACTIC CENTER, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VANCE RAY WARDEN D.C. (CHIROPRACTOR)
(228) 588-0188
Entity
Organization
Contact information
Practice address
19621 HWY 63, MOSS POINT, MS 39562
(228) 588-0188
(228) 588-9184
Mailing address
PO BOX 901, HURLEY, MS 39555-0901
(228) 588-0188
(228) 588-9184
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
987
MS
111N00000X
Chiropractor
—
—
207Q00000X
Family Medicine Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00123522
—
MS
01
—
587618900C
BLUE CROSS BLUE SHIELD
MS
Enumeration date
10/01/2008
Last updated
03/25/2022
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