Provider Demographics
NPI:1164290375
Name:CHANDLER, KATIE LEANN (DC)
Entity Type:Individual
Prefix:DR
First Name:KATIE
Middle Name:LEANN
Last Name:CHANDLER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:MS
Other - First Name:KATIE
Other - Middle Name:LEANN
Other - Last Name:NOWLIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:690 S TIMBERLANE DRIVE
Mailing Address - Street 2:SUITE C
Mailing Address - City:EL DURADO
Mailing Address - State:AR
Mailing Address - Zip Code:71730
Mailing Address - Country:US
Mailing Address - Phone:870-875-2225
Mailing Address - Fax:
Practice Address - Street 1:690 S TIMBERLANE DRIVE
Practice Address - Street 2:SUITE C
Practice Address - City:EL DURADO
Practice Address - State:AR
Practice Address - Zip Code:71730
Practice Address - Country:US
Practice Address - Phone:870-875-2225
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-18
Last Update Date:2023-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX15735111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor