Healthcare Provider Details

I. General information

NPI: 1265996557
Provider Name (Legal Business Name): WARREN FAMILY CHIROPRACTIC INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/31/2019
Last Update Date: 01/31/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4805 W HIGHLAND KNOLLS RD STE 200
ROGERS AR
72758-7027
US

IV. Provider business mailing address

5309 S 45TH ST
ROGERS AR
72758-8900
US

V. Phone/Fax

Practice location:
  • Phone: 479-372-7708
  • Fax:
Mailing address:
  • Phone: 314-443-2269
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DR. MICHAEL RYAN WARREN
Title or Position: OWNER
Credential: D.C.
Phone: 314-443-2269