Healthcare Provider Details

I. General information

NPI: 1437281342
Provider Name (Legal Business Name): CULPEPPER CHIROPRACTIC CENTER PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/09/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1203 S UNIVERSITY AVE
LITTLE ROCK AR
72204
US

IV. Provider business mailing address

1203 S UNIVERSITY AVE
LITTLE ROCK AR
72204
US

V. Phone/Fax

Practice location:
  • Phone: 501-296-9595
  • Fax: 501-296-9597
Mailing address:
  • Phone: 501-296-9595
  • Fax: 501-296-9597

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MS. CLAUDIA A HAZAGA
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 888-708-8886