Individual
CALEB FORTENBERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
2045 E PASS RD STE B, GULFPORT, MS 39507-3761
(228) 896-7574
(228) 896-7579
Mailing address
2045 E PASS RD STE B, GULFPORT, MS 39507-3761
(228) 896-7574
(228) 896-7574
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1314
MS
Other
Enumeration date
09/21/2020
Last updated
09/21/2020
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