Provider Demographics
NPI:1558032383
Name:THE MUSCLE AND JOINT CLINIC, PLLC
Entity Type:Organization
Organization Name:THE MUSCLE AND JOINT CLINIC, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CALEB
Authorized Official - Middle Name:MARSTON
Authorized Official - Last Name:ALFORD
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:662-301-8341
Mailing Address - Street 1:107 NW PLAZA DR
Mailing Address - Street 2:
Mailing Address - City:SENATOBIA
Mailing Address - State:MS
Mailing Address - Zip Code:38668
Mailing Address - Country:US
Mailing Address - Phone:662-689-0030
Mailing Address - Fax:
Practice Address - Street 1:107 NW PLAZA DR
Practice Address - Street 2:
Practice Address - City:SENATOBIA
Practice Address - State:MS
Practice Address - Zip Code:38668
Practice Address - Country:US
Practice Address - Phone:662-689-0030
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-22
Last Update Date:2023-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS1265837033Medicaid