Organization · NPI-2

Eagle'S Pointe Clinic Of Chiropractic LLC

Chiropractor · Hattiesburg, MS

NPI number1831435262
StatusActive
Last updated in NPPESApr 25, 2013

Details

NPI
1831435262
Entity type
Organization (NPI-2)
Legal business name
Eagle'S Pointe Clinic Of Chiropractic LLC
Organization subpart
No
Enumeration date
Dec 12, 2012
Last updated
Apr 25, 2013

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
111N00000X Chiropractor1194MSYes
111N00000X Chiropractor1198MS

Practice location

5910 U S Highway 49
Suite 15
Hattiesburg, MS 39401-7585

Phone 601-951-1908

Mailing address

116 Breckenridge Dr
Apt 103
Hattiesburg, MS 39402-3503

Authorized official

Lacresha Nicole Essex
Member
6019511908

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