Healthcare Provider Details

I. General information

NPI: 1831399393
Provider Name (Legal Business Name): BREANNA RENEE BATEY D.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: BREANNA RENEE BLOOM D.C.

II. Dates (important events)

Enumeration Date: 07/23/2007
Last Update Date: 03/26/2024
Certification Date: 03/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2901 E ZION RD STE 1
FAYETTEVILLE AR
72703-5070
US

IV. Provider business mailing address

2901 E ZION RD STE 1
FAYETTEVILLE AR
72703-5070
US

V. Phone/Fax

Practice location:
  • Phone: 479-879-9990
  • Fax:
Mailing address:
  • Phone: 479-879-9990
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number16192
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: