Healthcare Provider Details

I. General information

NPI: 1306910690
Provider Name (Legal Business Name): BETTS FAMILY CHIROPRACTIC INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/20/2006
Last Update Date: 03/25/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1811 EXECUTIVE SQUARE
JONESBORO AR
72401
US

IV. Provider business mailing address

1811 EXECUTIVE SQUARE
JONESBORO AR
72401
US

V. Phone/Fax

Practice location:
  • Phone: 870-931-3722
  • Fax: 870-802-0352
Mailing address:
  • Phone: 870-931-3722
  • Fax: 870-802-0352

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number1521
License Number StateAR

VIII. Authorized Official

Name: DR. PAUL DWIGHT BETTS JR.
Title or Position: CHIROPRACTOR OWNER
Credential: DC
Phone: 870-931-3722