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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