Provider Demographics
NPI:1235587437
Name:SHEARER, VICTORIA BASS (DC)
Entity Type:Individual
Prefix:DR
First Name:VICTORIA
Middle Name:BASS
Last Name:SHEARER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:MRS
Other - First Name:VICTORIA
Other - Middle Name:LYNN
Other - Last Name:BASS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:766 LAKELAND DR STE B
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MS
Mailing Address - Zip Code:39216-4610
Mailing Address - Country:US
Mailing Address - Phone:601-982-2916
Mailing Address - Fax:601-366-2916
Practice Address - Street 1:766 LAKELAND DR STE B
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MS
Practice Address - Zip Code:39216-4610
Practice Address - Country:US
Practice Address - Phone:601-982-2916
Practice Address - Fax:601-366-2916
Is Sole Proprietor?:No
Enumeration Date:2016-05-27
Last Update Date:2021-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS1259111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor