Provider Demographics
NPI:1962739623
Name:GARRETT FAMILY CHIROPRACTIC LLC
Entity type:Organization
Organization Name:GARRETT FAMILY CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:ALBERT
Authorized Official - Last Name:GARRETT
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:601-919-2800
Mailing Address - Street 1:5719 HIGHWAY 25
Mailing Address - Street 2:SUITE 5
Mailing Address - City:FLOWOOD
Mailing Address - State:MS
Mailing Address - Zip Code:39232-7105
Mailing Address - Country:US
Mailing Address - Phone:601-919-2800
Mailing Address - Fax:601-919-2900
Practice Address - Street 1:5719 HIGHWAY 25
Practice Address - Street 2:SUITE 5
Practice Address - City:FLOWOOD
Practice Address - State:MS
Practice Address - Zip Code:39232-7105
Practice Address - Country:US
Practice Address - Phone:601-919-2800
Practice Address - Fax:601-919-2900
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-17
Last Update Date:2010-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS910111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS1699916916OtherNPI