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Individual

DR. SHANE MARTIN HINCKLEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.C.

Contact information

Practice address
150 MARION AVE, MCCOMB, MS 39648-3620
(601) 684-9200
Mailing address
150 MARION AVE, MCCOMB, MS 39648-3620
(601) 684-9200

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
640923144
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00125195
MS
Enumeration date
02/05/2007
Last updated
03/12/2008
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