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Organization
MID-SOUTH CHIROPRACTIC, LLC
Active
Organization
MID-SOUTH CHIROPRACTIC, LLC
Active
Other names
MidSouth Chiropractic & Therapeutic Massage
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM LAWTON ALLEN D.C. (CHIROPRACTOR)
(662) 890-0012
Entity
Organization
Contact information
Practice address
6253 GOODMAN ROAD, SUITE A & B, OLIVE BRANCH, MS 38654-9391
(662) 890-0012
(662) 890-0522
Mailing address
6253 GOODMAN ROAD, SUITE A & B, OLIVE BRANCH, MS 38654-9391
(662) 890-0012
(662) 890-0522
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1518
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0111474
CIGNA
—
01
—
409574769
BLUE CROSS BLUE SHIELD MS
MS
01
—
4131570
BLUE CROSS BLUE SHIELD TN
—
01
—
701292
UNITED HEALTH CARE
—
01
—
7696844
AETNA
—
Enumeration date
06/09/2006
Last updated
04/02/2012
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