Provider Demographics
NPI:1043443328
Name:SANCHEZ CHIROPRACTIC CENTER, P.C.
Entity Type:Organization
Organization Name:SANCHEZ CHIROPRACTIC CENTER, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DR.
Authorized Official - Prefix:DR
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:N
Authorized Official - Last Name:SANCHEZ
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:662-423-9315
Mailing Address - Street 1:PO BOX 366
Mailing Address - Street 2:2009 CONSTITUTION DRIVE
Mailing Address - City:IUKA
Mailing Address - State:MS
Mailing Address - Zip Code:38852-0366
Mailing Address - Country:US
Mailing Address - Phone:662-423-9315
Mailing Address - Fax:662-423-9359
Practice Address - Street 1:2009 CONSTITUTION DR
Practice Address - Street 2:
Practice Address - City:IUKA
Practice Address - State:MS
Practice Address - Zip Code:38852-8457
Practice Address - Country:US
Practice Address - Phone:662-423-9315
Practice Address - Fax:662-423-9359
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-02
Last Update Date:2009-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS1054111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS00116414Medicaid
MS03422363Medicaid
MS03105570Medicaid
MS350001251Medicare PIN
MS03105570Medicaid