Organization
SOUTHERN CHIROPRACTIC OF DOUGLAS, INC.
Active
Other names
Southern Chiropractic of Douglas
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOSHUA BRETT MIZELL DC (OWNER/CHIROPRACTOR)
(912) 389-0042
Entity
Organization
Contact information
Practice address
506 ASHLEY ST W, DOUGLAS, GA 31533-2308
(912) 389-0042
Mailing address
506 ASHLEY ST W, DOUGLAS, GA 31533-2308
(912) 389-0042
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CHIR008807
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CHIR008807
PROFESSIONAL LICENSE
GA
Enumeration date
10/06/2017
Last updated
10/06/2017
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