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General NPI Number Information
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NPI Number | 1770634875
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Entity Type | Organization
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Legal Business Name | HOLDEN FAMILY CHIROPRACTIC CLINIC, P. A.
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Dates
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Enumeration Date | 01/15/2007
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Last Update Date | 04/20/2008
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Provider Practice Location Address
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Address Line | 109 S LAREDO AVE
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City | RUSSELLVILLE
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State | AR
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Zip | 72801-4853
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Country | US
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Telephone | 479-968-3338
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Fax | 479-890-6469
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Provider Business Mailing Address
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Address Line | 109 S LAREDO AVE
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City | RUSSELLVILLE
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State | AR
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Zip | 72801-4853
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Country | US
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Telephone | 479-968-3338
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Fax | 479-890-6469
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. LES M. HOLDEN
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Credential | DC
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Telephone | 479-968-3338
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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 | 1485
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License Number State | AR
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