Provider Demographics
NPI:1225157670
Name:ROSA MARIE MCLAURIN DC, INC
Entity Type:Organization
Organization Name:ROSA MARIE MCLAURIN DC, INC
Other - Org Name:LONOKE CHIROPRCTIC CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROSA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:MCLAURIN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:501-676-3600
Mailing Address - Street 1:1300 N CENTER ST
Mailing Address - Street 2:SUITE C
Mailing Address - City:LONOKE
Mailing Address - State:AR
Mailing Address - Zip Code:72086-2011
Mailing Address - Country:US
Mailing Address - Phone:501-676-3600
Mailing Address - Fax:501-676-0606
Practice Address - Street 1:1300 N CENTER ST
Practice Address - Street 2:SUITE C
Practice Address - City:LONOKE
Practice Address - State:AR
Practice Address - Zip Code:72086-2011
Practice Address - Country:US
Practice Address - Phone:501-676-3600
Practice Address - Fax:501-676-0606
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-28
Last Update Date:2008-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR1373111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty