Healthcare Provider Details

I. General information

NPI: 1578571220
Provider Name (Legal Business Name): T.K. HUTSON ENTERPRISES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/04/2006
Last Update Date: 02/02/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 EAST BROADWAY SUITE B
GLENWOOD AR
71943
US

IV. Provider business mailing address

PO BOX 825
GLENWOOD AR
71943-0825
US

V. Phone/Fax

Practice location:
  • Phone: 870-356-2019
  • Fax: 870-356-2070
Mailing address:
  • Phone: 870-356-2019
  • Fax: 870-356-2070

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VIII. Authorized Official

Name: DR. TERRY L HUTSON
Title or Position: DOCTOR OF CHIROPRACTIC
Credential: D.C.
Phone: 870-356-2019