Organization
LONGEVITY CHIROPRACTIC & WELLNESS CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GREGORY SCOTT MCCULLY D.C. (DOCTOR OF CHIROPRACTIC)
(601) 602-4056
Entity
Organization
Contact information
Practice address
55 98 PLACE BLVD, HATTIESBURG, MS 39402-8602
(601) 602-4056
(601) 602-4199
Mailing address
55 98 PLACE BLVD, HATTIESBURG, MS 39402-8602
(601) 602-4056
(601) 602-4199
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
994
MS
Other
Enumeration date
02/26/2010
Last updated
02/26/2010
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