Healthcare Provider Details

I. General information

NPI: 1821567249
Provider Name (Legal Business Name): AMANDA REBECCA STEWART DC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/14/2018
Last Update Date: 08/14/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2901 E ZION RD
FAYETTEVILLE AR
72703-5007
US

IV. Provider business mailing address

2901 E ZION RD
FAYETTEVILLE AR
72703-5007
US

V. Phone/Fax

Practice location:
  • Phone: 479-777-2733
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number13945
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number16199
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: