MEDICARE: DR. DENISE A CHANDLER DC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	1384	AR

General Provider Information

NPI Number	:	1154373421
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DENISE A CHANDLER DC

Provider Business Mailing Address
First Line	:	2023 E. MAIN ST.
Second Line	:	STE. C
City	:	SILOAM SPRINGS
State	:	AR
Zip	:	72761-5504
Country	:	US
Telephone Number	:	479-524-5555
Fax Number	:

Provider Business Practice Location Address
First Line	:	2023 E. MAIN ST.
Second Line	:	STE. C
City	:	SILOAM SPRINGS
State	:	AR
Zip	:	72761-5504
Country	:	US
Telephone Number	:	479-524-5555
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/16/2006
Last Update Date	:	06/04/2012

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