Organization
PRE-HAB, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HEATHER TANNER MCLENDON (OFFICE MANAGER)
(601) 932-3855
Entity
Organization
Contact information
Practice address
1000 LAKELAND SQUARE EXT STE 400, FLOWOOD, MS 39232-7621
(601) 932-3855
(601) 932-6557
Mailing address
1000 LAKELAND SQUARE EXT STE 400, FLOWOOD, MS 39232-7621
(601) 932-3855
(601) 932-6557
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1204
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01950356
—
MS
Enumeration date
02/20/2018
Last updated
02/20/2018
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