Healthcare Provider Details

I. General information

NPI: 1891582623
Provider Name (Legal Business Name): SPERO DISC CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/23/2025
Last Update Date: 04/23/2025
Certification Date: 04/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22 W COLT SQUARE DR
FAYETTEVILLE AR
72703-2813
US

IV. Provider business mailing address

22 W COLT SQUARE DR
FAYETTEVILLE AR
72703-2813
US

V. Phone/Fax

Practice location:
  • Phone: 479-799-7926
  • Fax: 479-888-7700
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111NI0900X
TaxonomyInternist Chiropractor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code111NN0400X
TaxonomyNeurology Chiropractor
License Number
License Number State

VIII. Authorized Official

Name: KATINKA VAN DER MERWE
Title or Position: OWNER
Credential:
Phone: 479-480-6677