Organization
MIDSOUTH INTEGRATIVE MEDICAL, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MEAGAN CHASTANT-QUALLS FNP (NURSE PRACTITIONER)
(662) 349-0980
Entity
Organization
Contact information
Practice address
7651 TCHULAHOMA RD, SOUTHAVEN, MS 38671-9227
(662) 349-0980
(662) 349-0980
Mailing address
7651 TCHULAHOMA RD, SOUTHAVEN, MS 38671-9227
(662) 349-0980
(662) 349-0980
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Enumeration date
07/01/2020
Last updated
03/19/2025
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