Qualls, Tyler Lane
Qualls, Tyler Lane is an individual health care provider with primary practice located at 7651 Tchulahoma Rd , Southaven MS 38671-9227. He recently has only one registered license in Chiropractic Providers / Chiropractor, which is considered as his primary health care specialty. Qualls, Tyler Lane can be contacted via phone (662) 349-0980.Contact Information
Primary practice address
7651 Tchulahoma Rd
Southaven MS 38671-9227
Phone: (662) 349-0980
Fax: (662) 349-0990
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Chiropractic Providers / Chiropractor | 111N00000X | 1147 | Mississippi |
Profile Details
| NPI number | 1154565794 |
|---|---|
| LBN Legal business name | Qualls, Tyler Lane |
| Credentials | Doctor of Chiropractic (DC) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 27th, 2009 |
| Last updated | Jun 30th, 2016 - about 10 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1154565794 | NPPES |
| Mississippi | Other | 302I355410 | MEDICARE PTAN |
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