Healthcare Provider Details

I. General information

NPI: 1053432690
Provider Name (Legal Business Name): TRACY HOWARD, DC,PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/02/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

877 BETHLEHEM RD
AUSTIN AR
72007-8975
US

IV. Provider business mailing address

877 BETHLEHEM RD
AUSTIN AR
72007-8975
US

V. Phone/Fax

Practice location:
  • Phone: 501-607-1421
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number1273
License Number StateAR

VIII. Authorized Official

Name: DR. TRACY LYNN HOWARD
Title or Position: PRESIDENT
Credential: DC
Phone: 501-607-1421