Healthcare Provider Details

I. General information

NPI: 1235071119
Provider Name (Legal Business Name): MR. AARON JENNINGS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

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

III. Provider practice location address

5300 S SOUTHERN HILLS CT # 200
ROGERS AR
72758-3500
US

IV. Provider business mailing address

1024 LAUX LN
PEA RIDGE AR
72751-6003
US

V. Phone/Fax

Practice location:
  • Phone: 507-456-3775
  • Fax:
Mailing address:
  • Phone: 507-456-3775
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: