Provider Demographics
NPI:1770671703
Name:CHIROPRACTIC SERVICES INC.
Entity Type:Organization
Organization Name:CHIROPRACTIC SERVICES INC.
Other - Org Name:BROWN CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MGR.
Authorized Official - Prefix:MRS
Authorized Official - First Name:POLLY
Authorized Official - Middle Name:F
Authorized Official - Last Name:HUGHES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:601-936-6650
Mailing Address - Street 1:4294 LAKELAND DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:FLOWOOD
Mailing Address - State:MS
Mailing Address - Zip Code:39232-9509
Mailing Address - Country:US
Mailing Address - Phone:601-936-6650
Mailing Address - Fax:601-936-6665
Practice Address - Street 1:4294 LAKELAND DR
Practice Address - Street 2:SUITE 100
Practice Address - City:FLOWOOD
Practice Address - State:MS
Practice Address - Zip Code:39232-9509
Practice Address - Country:US
Practice Address - Phone:601-936-6650
Practice Address - Fax:601-936-6665
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-11
Last Update Date:2008-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSMS917111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS09014521Medicaid
MSCH8502OtherPALMETTO
MSCH8502OtherPALMETTO