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General NPI Number Information
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NPI Number | 1750705901
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Entity Type | Organization
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Legal Business Name | BEARD FAMILY CHIROPRACTIC, LLC
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Dates
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Enumeration Date | 02/08/2014
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Last Update Date | 08/21/2014
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Provider Practice Location Address
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Address Line | 2415 PRINCE ST
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City | CONWAY
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State | AR
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Zip | 72034-3746
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Country | US
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Telephone | 501-208-7442
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Fax |
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Provider Business Mailing Address
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Address Line | 2415 PRINCE ST STE 103
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City | CONWAY
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State | AR
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Zip | 72034-3718
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Country | US
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Telephone | 501-208-7442
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. BRIAN BEARD
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Credential | DC
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Telephone | 501-208-7442
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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 | 16035
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License Number State | AR
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