Individual
BRIAN KEITH DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
12178 HIGHWAY 49 STE F, GULFPORT, MS 39503-3170
(228) 831-8181
(228) 831-8182
Mailing address
PO BOX 3304, GULFPORT, MS 39505-3304
(228) 831-8181
(228) 831-8182
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
780
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00120377
—
MS
01
—
5220674
AETNA
MS
Enumeration date
08/04/2006
Last updated
07/08/2013
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