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General NPI Number Information
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NPI Number | 1760155899
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Entity Type | Organization
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Legal Business Name | 60 MINUTE PAIN CLINIC, LLC
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Dates
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Enumeration Date | 07/26/2021
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Last Update Date | 12/23/2021
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Provider Practice Location Address
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Address Line | 6105 FATHER TRIBOU ST STE 46105
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City | LITTLE ROCK
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State | AR
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Zip | 72205-3027
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Country | US
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Telephone | 501-747-1320
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Fax | 501-747-1321
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Provider Business Mailing Address
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Address Line | 6105 FATHER TRIBOU ST STE 4
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City | LITTLE ROCK
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State | AR
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Zip | 72205-3027
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Country | US
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Telephone | 501-747-1320
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Fax | 501-747-1321
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Authorized Official
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Title or Position | OWNER
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Name | JOHN D'ONOFRIO
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Credential | DC
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Telephone | 501-217-9355
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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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