Healthcare Provider Details

I. General information

NPI: 1225157670
Provider Name (Legal Business Name): ROSA MARIE MCLAURIN DC, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/28/2007
Last Update Date: 08/07/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1300 N CENTER ST SUITE C
LONOKE AR
72086-2011
US

IV. Provider business mailing address

1300 N CENTER ST SUITE C
LONOKE AR
72086-2011
US

V. Phone/Fax

Practice location:
  • Phone: 501-676-3600
  • Fax: 501-676-0606
Mailing address:
  • Phone: 501-676-3600
  • Fax: 501-676-0606

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number1373
License Number StateAR

VIII. Authorized Official

Name: DR. ROSA MARIE MCLAURIN
Title or Position: OWNER/PRESIDENT
Credential: D.C.
Phone: 501-676-3600