Organization
MISSISSIPPI UPPER CERVICAL CLINIC, INC
Active
Other names
Midsouth Integrative Chiropractic
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TREVOR LAMAR QUALLS D.C. (CHIROPRACTOR)
(662) 349-0980
Entity
Organization
Contact information
Practice address
7651 TCHULAHOMA RD, SOUTHAVEN, MS 38671-9227
(662) 349-0980
(662) 349-0990
Mailing address
7651 TCHULAHOMA RD, SOUTHAVEN, MS 38671
(662) 349-0980
(662) 349-0990
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1100
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
415350960
BCBS
MS
Enumeration date
12/02/2006
Last updated
03/19/2025
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