Healthcare Provider Details

I. General information

NPI: 1154373421
Provider Name (Legal Business Name): DENISE A CHANDLER DC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/16/2006
Last Update Date: 06/04/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2023 E. MAIN ST. STE. C
SILOAM SPRINGS AR
72761-5504
US

IV. Provider business mailing address

2023 E. MAIN ST. STE. C
SILOAM SPRINGS AR
72761-5504
US

V. Phone/Fax

Practice location:
  • Phone: 479-524-5555
  • Fax:
Mailing address:
  • Phone: 479-524-5555
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number1384
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: