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Individual

DR. BRANDON SLOANE FORTINBERRY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.C.

Contact information

Practice address
1029 HIGHWAY 51 STE F2, MADISON, MS 39110-7648
(601) 605-0309
Mailing address
1029 HIGHWAY 51 STE F2, MADISON, MS 39110-7648
(601) 605-0309

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1189
MS
111NR0400X
Rehabilitation Chiropractor
721
MS

Other

Enumeration date
08/21/2012
Last updated
08/21/2012
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