Provider Demographics
NPI:1508009622
Name:TAKING KARE OF LIFE CHIROPRACTIC CLINIC
Entity Type:Organization
Organization Name:TAKING KARE OF LIFE CHIROPRACTIC CLINIC
Other - Org Name:TKL CHIROPRACTIC CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ZINNETTE
Authorized Official - Middle Name:CHERLYN
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:601-346-8199
Mailing Address - Street 1:7114 S SIWELL RD
Mailing Address - Street 2:
Mailing Address - City:BYRAM
Mailing Address - State:MS
Mailing Address - Zip Code:39272-8744
Mailing Address - Country:US
Mailing Address - Phone:601-346-8199
Mailing Address - Fax:601-346-8198
Practice Address - Street 1:7114 S SIWELL RD
Practice Address - Street 2:
Practice Address - City:BYRAM
Practice Address - State:MS
Practice Address - Zip Code:39272-8744
Practice Address - Country:US
Practice Address - Phone:601-346-8199
Practice Address - Fax:601-346-8198
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-20
Last Update Date:2009-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS1139111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty