Healthcare Provider Details

I. General information

NPI: 1376375915
Provider Name (Legal Business Name): HALEY FRERICHS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/14/2024
Last Update Date: 04/27/2026
Certification Date: 04/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12120 COLONEL GLENN RD STE 6200
LITTLE ROCK AR
72210-2370
US

IV. Provider business mailing address

12120 COLONEL GLENN RD STE 6200
LITTLE ROCK AR
72210-2370
US

V. Phone/Fax

Practice location:
  • Phone: 501-313-2844
  • Fax: 501-323-3754
Mailing address:
  • Phone: 501-313-2844
  • Fax: 501-323-3754

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number12412
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: