Organization
LUCEDALE CHIROPRACTIC CLINIC, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID ALAN SCHULTZ D.C. (PRESIDENT)
(601) 947-8472
Entity
Organization
Contact information
Practice address
789 WINTER ST, LUCEDALE, MS 39452-5729
(601) 947-8472
(601) 947-1672
Mailing address
789 WINTER ST, LUCEDALE, MS 39452-5729
(601) 947-8472
(601) 947-1672
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
610
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
06421772
—
MS
01
—
C02839
MEDICARE GROUP #
MS
Enumeration date
07/10/2007
Last updated
10/28/2010
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