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General NPI Number Information
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NPI Number | 1891084471
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Entity Type | Organization
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Legal Business Name | WALLACE HAYS FAMILY CHIROPRACTIC CLINIC, PA
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Dates
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Enumeration Date | 04/04/2011
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Last Update Date | 04/04/2011
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Provider Practice Location Address
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Address Line | 3111 JENNY LIND RD
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City | FORT SMITH
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State | AR
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Zip | 72901-6738
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Country | US
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Telephone | 479-783-0779
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Fax | 479-782-6442
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Provider Business Mailing Address
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Address Line | PO BOX 3996
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City | FORT SMITH
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State | AR
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Zip | 72913-3996
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Country | US
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Telephone | 479-783-0779
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Fax | 479-782-6442
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Authorized Official
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Title or Position | OWNER
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Name | DR. WALLACE HAYS
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Credential | DC
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Telephone | 479-783-0779
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | 929
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License Number State | AR
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