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Organization

MIDSOUTH SPINE AND PAIN ASSOCIATES PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
BRENT ALAN GRIMES NP-C (PARTNER)
(662) 284-8565
Entity
Organization

Contact information

Practice address
3037 CORDER DR, CORINTH, MS 38834-6216
(662) 284-8565
(662) 594-8366
Mailing address
PO BOX 1740, CORINTH, MS 38835-1740
(662) 284-8565
(662) 594-8366

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
1113
MS
111N00000X
Chiropractor
2148
TN
111N00000X
Chiropractor
687
TN
174400000X
Specialist
14758
MS
174400000X
Specialist
29331
TN
174400000X
Specialist
Primary
208VP0014X
Interventional Pain Medicine Physician
363LF0000X
Family Nurse Practitioner
8118957
TN

Other

Enumeration date
07/13/2012
Last updated
06/27/2023
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