Healthcare Provider Details

I. General information

NPI: 1912303975
Provider Name (Legal Business Name): ROCK CITY CHIROPRACTIC PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/18/2014
Last Update Date: 08/06/2025
Certification Date: 08/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

904 N DREW ST
STAR CITY AR
71667-5730
US

IV. Provider business mailing address

904 N DREW ST
STAR CITY AR
71667-5730
US

V. Phone/Fax

Practice location:
  • Phone: 501-916-9692
  • Fax: 501-916-9763
Mailing address:
  • Phone: 501-916-9692
  • Fax: 501-916-9763

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MRS. LAUREN VINCENT
Title or Position: OFFICE MANAGER
Credential:
Phone: 501-916-9692