Healthcare Provider Details

I. General information

NPI: 1043476930
Provider Name (Legal Business Name): BETTS FAMILY CHIROPRACTIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/31/2008
Last Update Date: 07/31/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1811 EXECUTIVE SQ
JONESBORO AR
72401-6086
US

IV. Provider business mailing address

1811 EXECUTIVE SQ
JONESBORO AR
72401-6086
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 Code111NI0013X
TaxonomyIndependent Medical Examiner Chiropractor
License Number1521
License Number StateAR

VIII. Authorized Official

Name: DR. PAUL D. BETTS JR.
Title or Position: OWNER/PRESIDENT
Credential: D.C.
Phone: 870-931-3722