Provider Demographics
NPI:1851931067
Name:MID SOUTH CHIROPRACTIC OF CLARKSDALE PLLC
Entity Type:Organization
Organization Name:MID SOUTH CHIROPRACTIC OF CLARKSDALE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:
Authorized Official - First Name:BRITTANY
Authorized Official - Middle Name:
Authorized Official - Last Name:KASPRACK
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:662-890-0012
Mailing Address - Street 1:218 DELTA AVE
Mailing Address - Street 2:
Mailing Address - City:CLARKSDALE
Mailing Address - State:MS
Mailing Address - Zip Code:38614-4213
Mailing Address - Country:US
Mailing Address - Phone:662-627-7640
Mailing Address - Fax:662-890-0522
Practice Address - Street 1:218 DELTA AVE
Practice Address - Street 2:
Practice Address - City:CLARKSDALE
Practice Address - State:MS
Practice Address - Zip Code:38614-4213
Practice Address - Country:US
Practice Address - Phone:662-627-7640
Practice Address - Fax:662-890-0522
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-15
Last Update Date:2020-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty