| NPI | 1295995728 |
|---|---|
| Doing Business As | HEALTHSOURCE OF SOUTHAVEN |
| Entity Type | Organization |
| Authorized Contact | VINCENT LAMONTE HENDERSON Owner 662-671-5255 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: MS 1129) |
| Enumeration Date | 2008-06-09 |
| Last Update Date | 2008-06-09 |