Healthcare Provider Details

I. General information

NPI: 1699086553
Provider Name (Legal Business Name): SHERROD CHIROPRACTIC, PLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/25/2010
Last Update Date: 06/25/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2512 ALEXANDER DR SUITE B
JONESBORO AR
72401-7175
US

IV. Provider business mailing address

2512 ALEXANDER DR SUITE B
JONESBORO AR
72401-7175
US

V. Phone/Fax

Practice location:
  • Phone: 870-934-8481
  • Fax: 870-934-8469
Mailing address:
  • Phone: 870-934-8481
  • Fax: 870-934-8469

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number15710
License Number StateAR

VIII. Authorized Official

Name: DR. JASON A SHERROD
Title or Position: OWNER/PROVIDER
Credential: D.C.
Phone: 870-934-8481