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General NPI Number Information
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NPI Number | 1134196488
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Entity Type | Individual
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Provider Name | LAURA R DOUGLAS D.C.
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Gender | Female
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Dates
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Enumeration Date | 03/07/2006
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Last Update Date | 05/20/2011
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Provider Practice Location Address
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Address Line | 908 S MAIN ST
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City | HOPE
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State | AR
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Zip | 71801-6525
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Country | US
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Telephone | 870-777-6161
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Fax | 870-777-9997
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Provider Business Mailing Address
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Address Line | PO BOX 988
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City | HOPE
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State | AR
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Zip | 71802-0988
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Country | US
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Telephone | 870-777-6161
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Fax | 870-777-9997
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 1506
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License Number State | AR
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