Organization
MAYWOOD CHIROPRACTIC CLINIC
Active
Other names
NORVILLE CHIROPRACTIC CLINIC
Organization subpart
No
Provider details
NPI number
Authorized official
MS. HEATHER TANNER MCLENDON (OFFICE MANAGER)
(601) 932-3855
Entity
Organization
Contact information
Practice address
1000 LAKELAND SQUARE EXT, SUITE 400, FLOWOOD, MS 39232-7620
(601) 932-3855
(601) 932-6557
Mailing address
1000 LAKELAND SQUARE EXT, SUITE 400, FLOWOOD, MS 39232-7620
(601) 932-3855
(601) 932-6557
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
124
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00115753
—
MS
01
—
302G351184
MEDICARE P-TAN
MS
Enumeration date
04/12/2010
Last updated
11/08/2010
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