Healthcare Provider Details

I. General information

NPI: 1285953638
Provider Name (Legal Business Name): CHIROWEST PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/25/2010
Last Update Date: 05/25/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1203 S UNIVERSITY AVE SUITE A
LITTLE ROCK AR
72204-2601
US

IV. Provider business mailing address

1203 S UNIVERSITY AVE SUITE A
LITTLE ROCK AR
72204-2601
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 Code305S00000X
TaxonomyPoint of Service
License Number1365
License Number StateAR

VIII. Authorized Official

Name: DR. CHRIS THOMAS CULPEPPER
Title or Position: OWNER/PRESIDENT
Credential: DC
Phone: 501-319-2633