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General NPI Number Information
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NPI Number | 1962444695
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Entity Type | Individual
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Provider Name | GERALD G ELSNER D.C
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Gender | Male
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Dates
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Enumeration Date | 06/10/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 3105 NE 11TH ST SUITE 3
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City | BENTONVILLE
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State | AR
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Zip | 72712-9102
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Country | US
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Telephone | 479-254-1177
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Fax | 479-254-1193
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Provider Business Mailing Address
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Address Line | 3105 NE 11TH ST SUITE 3
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City | BENTONVILLE
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State | AR
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Zip | 72712-9102
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Country | US
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Telephone | 479-254-1177
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Fax | 479-254-1193
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 7588
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License Number State | AR
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