Healthcare Provider Details

I. General information

NPI: 1578243861
Provider Name (Legal Business Name): CASIE OGDEN DC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/20/2023
Last Update Date: 07/20/2023
Certification Date: 07/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2655 DONAGHEY AVE
CONWAY AR
72032-2317
US

IV. Provider business mailing address

1070 S SAINT LOUIS ST
BATESVILLE AR
72501-7223
US

V. Phone/Fax

Practice location:
  • Phone: 501-459-5010
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number16400
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: