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Organization
SHUTTLEWORTH CHIROPRACTIC CENTRE PA
Active
Organization
SHUTTLEWORTH CHIROPRACTIC CENTRE PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK R SHUTTLEWORTH DC (CHIROPRACTOR)
(228) 896-3002
Entity
Organization
Contact information
Practice address
665 EAST PASS RD STE 3, GULFPORT, MS 39507
(228) 896-3002
(228) 897-1417
Mailing address
665 EAST PASS RD STE 3, GULFPORT, MS 39507
(228) 896-3002
(228) 897-1417
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
0753
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00115351
—
MS
Enumeration date
11/15/2006
Last updated
02/27/2019
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