Southern Regional Chiropractic and Rehabilitation Center

NPI #1134635360 in Diberville, Mississippi

Provider Information

NPI Number: 1134635360
Entity Type: Organization
Organization Name: Southern Regional Chiropractic and Rehabilitation Center
Primary Specialty: Chiropractor
Enumeration Date: Dec 26, 2017
Last Updated: Jul 10, 2018

Practice Location

Address: 11505 CINEMA DR STE 7
City: Diberville
State: Mississippi
ZIP Code: 39540
Phone: (228) 365-0449

Authorized Official

Name: MRS. SUSAN LEE KEENUM
Title: OWNER
Phone: (228) 860-5027

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Nurse Practitioner	363L00000X
Chiropractor	111N00000X	Primary

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