Provider Demographics
NPI:1477365765
Name:JERNIGAN CHIROPRACTIC CLINIC OS
Entity type:Organization
Organization Name:JERNIGAN CHIROPRACTIC CLINIC OS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LAUREN
Authorized Official - Middle Name:
Authorized Official - Last Name:WATSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:228-609-0265
Mailing Address - Street 1:2107A BIENVILLE BLVD # D4
Mailing Address - Street 2:
Mailing Address - City:OCEAN SPRINGS
Mailing Address - State:MS
Mailing Address - Zip Code:39564-3087
Mailing Address - Country:US
Mailing Address - Phone:228-215-8888
Mailing Address - Fax:
Practice Address - Street 1:2107A BIENVILLE BLVD # D4
Practice Address - Street 2:
Practice Address - City:OCEAN SPRINGS
Practice Address - State:MS
Practice Address - Zip Code:39564-3087
Practice Address - Country:US
Practice Address - Phone:228-215-8888
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-23
Last Update Date:2025-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty