Provider Demographics
NPI:1083969406
Name:TEECE, ERIK (DC)
Entity Type:Individual
Prefix:
First Name:ERIK
Middle Name:
Last Name:TEECE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3900 N PARKVIEW DR
Mailing Address - Street 2:SUITE 203
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72703-6398
Mailing Address - Country:US
Mailing Address - Phone:479-443-6768
Mailing Address - Fax:479-715-8088
Practice Address - Street 1:3900 N PARKVIEW DR
Practice Address - Street 2:SUITE 203
Practice Address - City:FAYETTEVILLE
Practice Address - State:AR
Practice Address - Zip Code:72703-6398
Practice Address - Country:US
Practice Address - Phone:479-443-6768
Practice Address - Fax:479-715-8088
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-23
Last Update Date:2013-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR16003111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor