| NPI | 1811249667 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRANDON SLOANE FORTINBERRY Dr./Owner 601-605-0903 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: MS 1189) |
| Enumeration Date | 2012-10-03 |
| Last Update Date | 2012-11-21 |