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General NPI Number Information
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NPI Number | 1134617848
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Entity Type | Organization
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Legal Business Name | IGNITE CHIROPRACTIC PLLC
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Dates
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Enumeration Date | 04/27/2018
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Last Update Date | 04/27/2018
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Provider Practice Location Address
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Address Line | 4305 S PLEASANT CROSSING BLVD STE 102
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City | ROGERS
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State | AR
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Zip | 72758-1347
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Country | US
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Telephone | 405-771-0668
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Fax |
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Provider Business Mailing Address
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Address Line | 4101 W HUNTINGTON DR APT 2308
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City | ROGERS
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State | AR
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Zip | 72758-4191
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Country | US
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Telephone | 740-381-0818
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Fax |
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Authorized Official
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Title or Position | CO-OWNER/CHIROPRACTOR
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Name | DR. NATALIE M HORINE
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Credential | DC, MS
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Telephone | 740-381-0818
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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 | T16188
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License Number State | AR
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