Organization
BACK CARE CENTER, INC.
Active
Other names
Reservoir Chiropractic-Back Care Center, Inc.
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES V MATHEWS M.S., D. C. (CHIROPRACTOR)
(601) 992-3050
Entity
Organization
Contact information
Practice address
1149 OLD FANNIN RD, SUITE 22, BRANDON, MS 39047-9244
(601) 992-3050
(601) 992-3051
Mailing address
1149 OLD FANNIN RD, SUITE 22, BRANDON, MS 39047-9244
(601) 992-3050
(601) 992-3051
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
0230
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
350000104
MEDICARE IDENTIFICATION NUMBER
MS
Enumeration date
08/11/2008
Last updated
09/15/2008
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