Provider Demographics
NPI:1689736274
Name:BMR CHIROPRACTIC, PC
Entity Type:Organization
Organization Name:BMR CHIROPRACTIC, PC
Other - Org Name:CHIROPRACTIC NEUROLOGY CENTER OF TUPELO
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SANDY
Authorized Official - Middle Name:
Authorized Official - Last Name:GANN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:662-844-1414
Mailing Address - Street 1:398 N EASON BLVD
Mailing Address - Street 2:
Mailing Address - City:TUPELO
Mailing Address - State:MS
Mailing Address - Zip Code:38804-7500
Mailing Address - Country:US
Mailing Address - Phone:662-844-1414
Mailing Address - Fax:622-844-7534
Practice Address - Street 1:398 N EASON BLVD
Practice Address - Street 2:
Practice Address - City:TUPELO
Practice Address - State:MS
Practice Address - Zip Code:38804-7500
Practice Address - Country:US
Practice Address - Phone:662-844-1414
Practice Address - Fax:622-844-7534
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-14
Last Update Date:2016-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty