Individual
DR. MARK READ SHUTTLEWORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
665 EAST PASS RD STE 3, GULFPORT, MS 39507
(228) 896-3002
Mailing address
665 E 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
01/16/2018
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