Healthcare Provider Details

I. General information

NPI: 1881446003
Provider Name (Legal Business Name): RAMONA LEE MCNEAL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/02/2024
Last Update Date: 04/02/2024
Certification Date: 03/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 ORCHARD DR
BERRYVILLE AR
72616-5013
US

IV. Provider business mailing address

601 ORCHARD DR
BERRYVILLE AR
72616-5013
US

V. Phone/Fax

Practice location:
  • Phone: 870-423-6969
  • Fax: 870-423-2830
Mailing address:
  • Phone: 870-423-6969
  • Fax: 870-423-2830

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number952
License Number StateAR
# 2
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number1320
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: