Organization Name: | LIVING PROOF CHIROPRACTIC-PLLC |
NPI Number: | 1811252901 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | CONNIE D. FULMER (SOLE MBR) |
Mailing Address: | 218 Hwy 30 W New Albany |
State: | MS US |
Postal Code: | 386523112 |
Phone Number: | 6625397013 |
Fax Number: | 6625397014 |
NPI Enumeration Date: | 07/05/2012 |
NPI Last Update Date: | 07/23/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 111N00000X |
License Number: | 0000002577 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | TN |
Taxonomy Type: | Chiropractic Providers |
Taxonomy Classification: | Chiropractor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |