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General NPI Number Information
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NPI Number | 1235480716
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Entity Type | Organization
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Legal Business Name | LAKE HAMILTON FAMILY CHIROPRACTIC PLLC
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Dates
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Enumeration Date | 09/25/2012
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Last Update Date | 07/29/2020
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Provider Practice Location Address
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Address Line | 1880 AIRPORT RD STE B
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City | HOT SPRINGS
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State | AR
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Zip | 71913-2117
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Country | US
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Telephone | 501-762-9648
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Fax | 501-463-9196
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Provider Business Mailing Address
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Address Line | 1880 AIRPORT RD STE B
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City | HOT SPRINGS
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State | AR
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Zip | 71913-2117
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Country | US
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Telephone | 501-762-9648
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Fax | 501-463-9196
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Authorized Official
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Title or Position | CHIROPRACTOR
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Name | DR. TYLER J KIGHT
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Credential | D.C.
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Telephone | 501-762-9648
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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 | 15999
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License Number State | AR
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