Provider Demographics
NPI:1811258528
Name:RUTHERFORD CHIROPRACTIC NEUROLOGY CENTER, PLLC
Entity type:Organization
Organization Name:RUTHERFORD CHIROPRACTIC NEUROLOGY CENTER, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:RUTHERFORD
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:662-448-5747
Mailing Address - Street 1:332 E MADISON ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:MS
Mailing Address - Zip Code:38851-2321
Mailing Address - Country:US
Mailing Address - Phone:662-448-5747
Mailing Address - Fax:662-448-5751
Practice Address - Street 1:332 E MADISON ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:MS
Practice Address - Zip Code:38851-2321
Practice Address - Country:US
Practice Address - Phone:662-448-5747
Practice Address - Fax:662-448-5751
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-30
Last Update Date:2012-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS1006111NN0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NN0400XChiropractic ProvidersChiropractorNeurologyGroup - Single Specialty