Provider Demographics
NPI:1043476930
Name:BETTS FAMILY CHIROPRACTIC
Entity Type:Organization
Organization Name:BETTS FAMILY CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:D
Authorized Official - Last Name:BETTS
Authorized Official - Suffix:JR
Authorized Official - Credentials:DC
Authorized Official - Phone:870-931-3722
Mailing Address - Street 1:1811 EXECUTIVE SQ
Mailing Address - Street 2:
Mailing Address - City:JONESBORO
Mailing Address - State:AR
Mailing Address - Zip Code:72401-6086
Mailing Address - Country:US
Mailing Address - Phone:870-931-3722
Mailing Address - Fax:870-802-0352
Practice Address - Street 1:1811 EXECUTIVE SQ
Practice Address - Street 2:
Practice Address - City:JONESBORO
Practice Address - State:AR
Practice Address - Zip Code:72401-6086
Practice Address - Country:US
Practice Address - Phone:870-931-3722
Practice Address - Fax:870-802-0352
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-31
Last Update Date:2008-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR1521111NI0013X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NI0013XChiropractic ProvidersChiropractorIndependent Medical ExaminerGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR5U532OtherBCBS
AR7119090OtherAETNA
AR1972677268OtherTYPE 1 NPI#
AR5U532OtherBCBS