Provider Demographics
NPI:1376593582
Name:PRINGLE, MITZI GALE (DC)
Entity Type:Individual
Prefix:DR
First Name:MITZI
Middle Name:GALE
Last Name:PRINGLE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1217 COURT STREET
Mailing Address - Street 2:
Mailing Address - City:PARAGOULD
Mailing Address - State:AR
Mailing Address - Zip Code:72450-4133
Mailing Address - Country:US
Mailing Address - Phone:870-926-8802
Mailing Address - Fax:
Practice Address - Street 1:1217 COURT STREET
Practice Address - Street 2:
Practice Address - City:PARAGOULD
Practice Address - State:AR
Practice Address - Zip Code:72450-4133
Practice Address - Country:US
Practice Address - Phone:870-926-8802
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-10
Last Update Date:2012-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR1672111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR163933718Medicaid
AR163933718Medicaid