Individual
CHASTITY BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DC
Contact information
Practice address
1630 GOODMAN RD E STE 3, SOUTHAVEN, MS 38671-9556
(901) 217-7173
(662) 932-8774
Mailing address
8101 HACKS CROSS RD STE 110, OLIVE BRANCH, MS 38654-4032
(901) 221-7173
(662) 932-8774
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1398
MS
111N00000X
Chiropractor
3873
TN
Other
Enumeration date
07/23/2024
Last updated
10/31/2024
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