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General NPI Number Information
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NPI Number | 1174535124
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Entity Type | Organization
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Legal Business Name | PAIN CARE ASSOCIATES P A
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Dates
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Enumeration Date | 08/11/2006
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Last Update Date | 07/13/2011
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Provider Practice Location Address
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Address Line | 8801 W MARKHAM ST
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City | LITTLE ROCK
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State | AR
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Zip | 72205-2316
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Country | US
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Telephone | 501-223-3314
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Fax | 501-223-8023
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Provider Business Mailing Address
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Address Line | 8801 W MARKHAM ST
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City | LITTLE ROCK
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State | AR
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Zip | 72205-2316
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Country | US
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Telephone | 501-223-3314
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Fax | 501-223-8023
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Authorized Official
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Title or Position | OFFICER
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Name | DWIGHT K STEWART
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Credential | D.C.
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Telephone | 501-223-3314
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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 | MC-2108
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License Number State | AR
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