Provider Demographics
NPI:1508932690
Name:RATHBURN, ALAN N (DC)
Entity Type:Individual
Prefix:DR
First Name:ALAN
Middle Name:N
Last Name:RATHBURN
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 1:612 HIGHWAY 80 E
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:MS
Mailing Address - Zip Code:39056-5123
Mailing Address - Country:US
Mailing Address - Phone:601-924-4647
Mailing Address - Fax:601-926-4799
Practice Address - Street 1:612 HIGHWAY 80 E
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:MS
Practice Address - Zip Code:39056-5123
Practice Address - Country:US
Practice Address - Phone:601-924-4647
Practice Address - Fax:601-926-4799
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-28
Last Update Date:2014-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS734111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor