Provider Demographics
NPI:1477754737
Name:TOULME', BRADY EVERETT (DC)
Entity Type:Individual
Prefix:DR
First Name:BRADY
Middle Name:EVERETT
Last Name:TOULME'
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:JACKSON COUNTY CHIROPRACTIC CLINIC
Mailing Address - Street 2:8820 HIGHWAY 613
Mailing Address - City:ESCATAWPA
Mailing Address - State:MS
Mailing Address - Zip Code:39552
Mailing Address - Country:US
Mailing Address - Phone:228-475-0673
Mailing Address - Fax:228-475-0678
Practice Address - Street 1:JACKSON COUNTY CHIROPRACTIC CLINIC
Practice Address - Street 2:8820 HIGHWAY 613
Practice Address - City:ESCATAWPA
Practice Address - State:MS
Practice Address - Zip Code:39552
Practice Address - Country:US
Practice Address - Phone:228-475-0673
Practice Address - Fax:228-475-0678
Is Sole Proprietor?:No
Enumeration Date:2007-05-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS973111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor