NPI 1366627606 · live from the CMS NPI Registry
Back Clinic, LLC
Family Medicine in Flowood, MS. National Provider Identifier 1366627606, active.
NPI record
| NPI | 1366627606 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Family Medicine 207Q00000X |
| Practice location | 1050 N Flowood Dr, Suite A-1, Flowood, MS 39232 |
| Practice phone | 601-936-3515 |
| Enumerated | January 7, 2008 |
| Last updated | January 7, 2008 |
| Authorized official | Lisa Cross, Co-Owner |
| Other names | Back Clinic Of Mississippi |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Family Medicine primary | 207Q00000X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.