Provider Demographics
NPI:1245390871
Name:PEARSON CHIROPRACTIC CLINIC PA
Entity Type:Organization
Organization Name:PEARSON CHIROPRACTIC CLINIC PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RAY
Authorized Official - Middle Name:A
Authorized Official - Last Name:PEARSON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:870-741-7300
Mailing Address - Street 1:701 N WALNUT ST
Mailing Address - Street 2:SUITE C
Mailing Address - City:HARRISON
Mailing Address - State:AR
Mailing Address - Zip Code:72601-3619
Mailing Address - Country:US
Mailing Address - Phone:870-741-7300
Mailing Address - Fax:870-741-3257
Practice Address - Street 1:701 N WALNUT ST
Practice Address - Street 2:SUITE C
Practice Address - City:HARRISON
Practice Address - State:AR
Practice Address - Zip Code:72601-3619
Practice Address - Country:US
Practice Address - Phone:870-741-7300
Practice Address - Fax:870-741-3257
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-12
Last Update Date:2007-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR915111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty