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Organization
MISSISSIPPI UPPER CERVICAL CLINIC, INC
Active
Organization
MISSISSIPPI UPPER CERVICAL CLINIC, INC
Active
Other names
Midsouth Integrative Chiropractic
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TREVOR LAMAR QUALLS D.C. (CHIROPRACTOR)
(662) 349-0980
Entity
Organization
Contact information
Practice address
7651 TCHULAHOMA RD, SOUTHAVEN, MS 38671-9227
(662) 349-0980
(662) 349-0990
Mailing address
7651 TCHULAHOMA RD, SOUTHAVEN, MS 38671
(662) 349-0980
(662) 349-0990
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1100
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
415350960
BCBS
MS
Enumeration date
12/02/2006
Last updated
03/19/2025
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