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General NPI Number Information
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NPI Number | 1144474438
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Entity Type | Organization
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Legal Business Name | LIGHT'S CHIROPRACTIC HEALTH CENTER
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Dates
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Enumeration Date | 11/12/2008
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Last Update Date | 11/12/2008
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Provider Practice Location Address
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Address Line | 325 SOUTHWEST DR SUITE B
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City | JONESBORO
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State | AR
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Zip | 72401-5854
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Country | US
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Telephone | 870-933-9600
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Fax |
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Provider Business Mailing Address
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Address Line | 802 HESTER ST APT B3
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City | JONESBORO
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State | AR
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Zip | 72401-3785
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Country | US
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Telephone | 870-933-9600
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Fax |
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Authorized Official
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Title or Position | CHIROPRACTOR
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Name | DR. NATAUSHA DIONNE LIGHT
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Credential | D.C.
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Telephone | 870-933-9600
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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 | 1686
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License Number State | AR
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