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Organization
JBCHIRO1 LLC
Active
Organization
JBCHIRO1 LLC
Active
Other names
Advanced Chiropractic and Wellness
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN BAMBAN DC (OWNER)
(228) 207-6427
Entity
Organization
Contact information
Practice address
11516 LAMEY BRIDGE RD, SUITE E, DIBERVILLE, MS 39540-2725
(228) 207-6427
(228) 207-6428
Mailing address
11516 LAMEY BRIDGE RD, SUITE E, DIBERVILLE, MS 39540-2725
(228) 207-6427
(228) 207-6428
Taxonomy
Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
Primary
1179
MS
Other
Enumeration date
11/05/2015
Last updated
11/05/2015
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