| Southern Regional Chiropractic And Rehabilitation Center | |
|
11505 Cinema Dr Ste 7, Diberville, MS 39540 | |
| (228) 365-0449 | |
| (228) 365-2314 |
| Full Name | Southern Regional Chiropractic And Rehabilitation Center |
|---|---|
| Type | Facility |
| Speciality | Chiropractor |
| Location | 11505 Cinema Dr Ste 7, Diberville, Mississippi |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134635360 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 111N00000X | Chiropractor | 1221 (Mississippi) | Primary |
| 363L00000X | Nurse Practitioner | 901566 (Mississippi) | Secondary |
| Provider Name | Bernard Keenum |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1760654925 PECOS PAC ID: 0648348862 Enrollment ID: I20140611001168 |
| Mailing Address | Practice Location Address |
|---|---|
| Southern Regional Chiropractic And Rehabilitation Center 11505 Cinema Dr Ste 7, Diberville, MS 39540-9703 Ph: (228) 365-0449 | Southern Regional Chiropractic And Rehabilitation Center 11505 Cinema Dr Ste 7, Diberville, MS 39540 Ph: (228) 365-0449 |
Dr. John Mackertich Bamban, DC Chiropractor Medicare: Accepting Medicare Assignments Practice Location: 11516 Lamey Bridge Rd Ste E, Diberville, MS 39540 Phone: 228-207-6427 Fax: 228-207-6428 | |
Bernard Keenum, Llc Chiropractor Medicare: Not Enrolled in Medicare Practice Location: 11505 Cinema Dr Ste 7, Diberville, MS 39540 Phone: 228-365-0449 Fax: 228-365-2314 | |
Nicholas Andrew Lococo, D.C. Chiropractor Medicare: Accepting Medicare Assignments Practice Location: 4242 Popps Ferry Rd Ste A, Diberville, MS 39540 Phone: 228-392-5543 | |
Lococo Health And Wellness Inc Chiropractor Medicare: Medicare Enrolled Practice Location: 4242 Popps Ferry Rd Ste A, Diberville, MS 39540 Phone: 228-392-5543 Fax: 228-392-5541 | |
Dr. Bernard Joseph Keenum, D.C. Chiropractor Medicare: Accepting Medicare Assignments Practice Location: 11505 Cinema Dr Ste 7, Diberville, MS 39540 Phone: 228-365-0449 Fax: 228-365-2314 |