Organization
JACKSON COUNTY CHIROPRACTIC CLINIC PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GARY LEE BRANHAM (OWNER)
(228) 475-0676
Entity
Organization
Contact information
Practice address
8820 HIGHWAY 613, MOSS POINT, MS 39562-8102
(228) 475-0676
Mailing address
PO BOX 656, ESCATAWPA, MS 39552-0656
(228) 475-0676
(228) 475-0678
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
0429
MS
Other
Enumeration date
08/26/2008
Last updated
08/26/2008
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