Organization
BALLARD CHIROPRACTIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HARVEY MACK BALLARD II D.C., F.I.C.C. (OWNER)
(662) 226-4388
Entity
Organization
Contact information
Practice address
1301I SUNSET DR, GRENADA, MS 38901-4003
(662) 226-4388
(662) 226-4538
Mailing address
PO BOX 1291, GRENADA, MS 38902-1291
(662) 226-4388
(662) 226-4538
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
0021
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00115516
—
MS
05
—
00503669
—
MS
01
—
424480961A
BLUE CROSS
MS
Enumeration date
08/28/2007
Last updated
05/13/2009
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