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General NPI Number Information
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NPI Number | 1346686391
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Entity Type | Organization
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Legal Business Name | BETTER BODY SOLUTIONS PLLC
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Dates
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Enumeration Date | 05/17/2013
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Last Update Date | 05/17/2013
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Provider Practice Location Address
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Address Line | 902B S WALTON BLVD SUITE 18
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City | BENTONVILLE
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State | AR
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Zip | 72712-6237
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Country | US
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Telephone | 479-925-8623
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Fax |
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Provider Business Mailing Address
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Address Line | 902B S WALTON BLVD SUITE 18
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City | BENTONVILLE
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State | AR
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Zip | 72712-6237
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Country | US
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Telephone | 479-925-8623
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | DR. RYAN DALE HASENCLEVER
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Credential | D.C.
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Telephone | 479-925-8623
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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 | 1705
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License Number State | AR
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