| Desoto County Chiropractic, Inc. | |
|
1134 Church Rd W Southaven MS 38671-7144 | |
| (662) 393-4848 | |
| (662) 393-4858 |
| Full Name | Desoto County Chiropractic, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 1134 Church Rd W, Southaven, Mississippi |
| Authorized Official Name and Position | David Chadwick Hall (PRESIDENT) |
| Authorized Official Contact | 9013383886 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Desoto County Chiropractic, Inc. Po Box 175 Nesbit MS 38651-0175 Ph: (662) 393-4848 | Desoto County Chiropractic, Inc. 1134 Church Rd W Southaven MS 38671-7144 Ph: (662) 393-4848 |
| NPI Number | 1376882050 |
|---|---|
| Provider Enumeration Date | 01/31/2013 |
| Last Update Date | 01/31/2013 |
| Medicare PECOS PAC ID | 4981918463 |
|---|---|
| Medicare Enrollment ID | O20150728004308 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376882050 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Secondary |
| 261QH0100X | Clinic/center - Health Service | (* (Not Available)) | Primary |
| Provider Name | David C Hall |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1275565285 PECOS PAC ID: 7012911688 Enrollment ID: I20141230001935 |
| Provider Name | Troy A Reistroffer |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1104838259 PECOS PAC ID: 2567512445 Enrollment ID: I20150729007941 |
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