Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 962 | MS |
NPI | 1003983420 |
---|---|
Provider Name | Dr. Paul Alan Little |
First Address | Bay Springs, MS 39422-0051 |
Second Address | Bay Springs, MS 39422 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/11/2006 |
Last Update Date | 09/03/2012 |