Provider Demographics
NPI:1073096012
Name:FLETCHER CHIROPRACTIC HEALTH CENTER PLLC
Entity Type:Organization
Organization Name:FLETCHER CHIROPRACTIC HEALTH CENTER PLLC
Other - Org Name:CHIROPRACTIC HEALTH CENTER OF BRYANT
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER/CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MIRANDA
Authorized Official - Middle Name:MILLER
Authorized Official - Last Name:TIPTON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:501-847-4691
Mailing Address - Street 1:PO BOX 2825
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN VIEW
Mailing Address - State:AR
Mailing Address - Zip Code:72560-2825
Mailing Address - Country:US
Mailing Address - Phone:870-213-6361
Mailing Address - Fax:870-269-2226
Practice Address - Street 1:23253 I 30
Practice Address - Street 2:
Practice Address - City:BRYANT
Practice Address - State:AR
Practice Address - Zip Code:72022-2571
Practice Address - Country:US
Practice Address - Phone:501-847-7246
Practice Address - Fax:870-269-2226
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-14
Last Update Date:2022-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty