Organization
BACK ROOM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATANYA FORD D.C. (CHIROPRACTOR)
(228) 331-2035
Entity
Organization
Contact information
Practice address
15312 DEDEAUX RD, SUITE A, GULFPORT, MS 39503-3123
(228) 331-2035
Mailing address
15312 DEDEAUX RD, SUITE A, GULFPORT, MS 39503-3123
(228) 331-2035
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1162
MS
Other
Enumeration date
06/05/2012
Last updated
06/13/2012
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