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Organization

ADVANCED CHIROPRACTIC CLINIC

Active
Other names
Back & Neck Pain Clinic Dr L C Huddleston
Organization subpart
No

Provider details

NPI number
Authorized official
DR. LEO C HUDDLESTON DC (OWNER)
(601) 953-0010
Entity
Organization

Contact information

Practice address
6500 OLD CANTON RD, RIDGELAND, MS 39157-1313
(601) 956-0010
Mailing address
6500 OLD CANTON RD, RIDGELAND, MS 39157-1313
(601) 956-0010

Taxonomy

Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
624
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00115050
MS
Enumeration date
06/12/2012
Last updated
06/13/2012
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