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General NPI Number Information
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NPI Number | 1932111218
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Entity Type | Organization
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Legal Business Name | BACK IN ACTION CHIROPRACTIC, LLC
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Dates
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Enumeration Date | 08/13/2006
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Last Update Date | 02/07/2023
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Provider Practice Location Address
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Address Line | 1307 S PINE ST
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City | CABOT
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State | AR
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Zip | 72023-3811
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Country | US
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Telephone | 501-843-2222
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Fax | 501-843-2277
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Provider Business Mailing Address
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Address Line | 1307 S PINE ST
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City | CABOT
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State | AR
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Zip | 72023-3811
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Country | US
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Telephone | 501-843-2222
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Fax | 501-843-2277
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Authorized Official
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Title or Position | OWNER
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Name | DR. PHILIP DEREK JONES
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Credential | D.C.
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Telephone | 501-843-2222
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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 | 15620
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License Number State | AR
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