Individual
DR. TREVOR LAMAR QUALLS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
7651 TCHULAHOMA RD, SOUTHAVEN, MS 38671-9227
(662) 349-0980
(662) 349-0990
Mailing address
7651 TCHULAHOMA RD, SOUTHAVEN, MS 38671-9227
(662) 349-0980
(662) 349-0990
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1100
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04207282
—
MS
01
—
302I352733
MEDICARE PTAN
MS
Enumeration date
09/22/2006
Last updated
03/19/2025
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