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Individual

DR. NIKOLAS RAMONE CHILLIES

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.C.

Contact information

Practice address
6253 GOODMAN RD, SUITE A & B, OLIVE BRANCH, MS 38654-9391
(662) 890-0012
(662) 890-0522
Mailing address
6253 GOODMAN RD, SUITE A & B, OLIVE BRANCH, MS 38654-9391
(662) 890-0012
(662) 890-0522

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1092
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0111474
CIGNA PROVIDER ID
MS
01
4131570
BCBS TN PROVIDER ID
TN
01
5706402
FIRST HEALTH PROVIDER ID
MS
01
701292
UNITED HEALTHCARE
MS
01
7696844
AETNA PROVIDER ID
MS
Enumeration date
06/12/2006
Last updated
07/09/2007
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