Organization
HWY 63 MEDICAL AND CHIROPRACTIC CENTER, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VANCE RAY WARDEN D.C. (CHIROPRACTOR)
(228) 588-0188
Entity
Organization
Contact information
Practice address
19621 HWY 63, MOSS POINT, MS 39562
(228) 588-0188
(228) 588-9184
Mailing address
PO BOX 901, HURLEY, MS 39555-0901
(228) 588-0188
(228) 588-9184
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
987
MS
111N00000X
Chiropractor
—
—
207Q00000X
Family Medicine Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00123522
—
MS
01
—
587618900C
BLUE CROSS BLUE SHIELD
MS
Enumeration date
10/01/2008
Last updated
03/25/2022
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