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General NPI Number Information
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NPI Number | 1649459512
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Entity Type | Organization
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Legal Business Name | HARRAH FAMILY CHIROPRACTIC CLINIC
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Dates
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Enumeration Date | 10/29/2007
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Last Update Date | 10/29/2007
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Provider Practice Location Address
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Address Line | 1007 WINDOVER RD STE C
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City | JONESBORO
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State | AR
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Zip | 72401-6009
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Country | US
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Telephone | 870-933-9085
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Fax | 870-933-9154
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Provider Business Mailing Address
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Address Line | PO BOX 16841
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City | JONESBORO
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State | AR
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Zip | 72403-6714
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Country | US
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Telephone | 870-933-9085
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Fax | 870-933-9154
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Authorized Official
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Title or Position | DOCTOR
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Name | DR. KEVIN D HARRAH
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Credential | D.C.
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Telephone | 870-933-9085
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 1323
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License Number State | AR
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