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General NPI Number Information
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NPI Number | 1487128955
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Entity Type | Organization
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Legal Business Name | SANTOS CHIROPRACTIC PLLC
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Dates
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Enumeration Date | 01/17/2019
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Last Update Date | 01/17/2019
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Provider Practice Location Address
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Address Line | 1706 SE WALTON BLVD STE 6
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City | BENTONVILLE
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State | AR
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Zip | 72712-3201
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Country | US
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Telephone | 479-464-4413
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Fax | 479-464-4430
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Provider Business Mailing Address
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Address Line | 1706 SE WALTON BLVD STE 6
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City | BENTONVILLE
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State | AR
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Zip | 72712-3201
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Country | US
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Telephone | 479-464-4413
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Fax | 479-464-4430
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Authorized Official
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Title or Position | OWNER
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Name | DR. ERIC BRIAN SANTOS
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Credential | DC
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Telephone | 479-464-4413
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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 |
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License Number State |
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