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General NPI Number Information
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NPI Number | 1740746049
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Entity Type | Individual
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Provider Name | DUSTIN WORTHEN DC
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Gender | Male
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Dates
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Enumeration Date | 02/12/2019
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Last Update Date | 01/31/2024
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Provider Practice Location Address
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Address Line | 12400 CANTRELL RD STE 5
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City | LITTLE ROCK
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State | AR
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Zip | 72223-1706
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Country | US
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Telephone | 501-471-9560
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Fax |
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Provider Business Mailing Address
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Address Line | 4108 LAKEVIEW RD
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City | NORTH LITTLE ROCK
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State | AR
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Zip | 72116-7331
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Country | US
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Telephone | 256-420-7693
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 16217
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License Number State | AR
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