Provider Demographics
NPI:1376596239
Name:NATURAL HEALTHCARE CLINIC
Entity Type:Organization
Organization Name:NATURAL HEALTHCARE CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:CLAY
Authorized Official - Middle Name:M
Authorized Official - Last Name:BERGER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:479-636-9495
Mailing Address - Street 1:PO BOX 1023
Mailing Address - Street 2:
Mailing Address - City:ROGERS
Mailing Address - State:AR
Mailing Address - Zip Code:72757
Mailing Address - Country:US
Mailing Address - Phone:479-636-9495
Mailing Address - Fax:479-636-9449
Practice Address - Street 1:3301 W HUDSON ROAD
Practice Address - Street 2:
Practice Address - City:ROGERS
Practice Address - State:AR
Practice Address - Zip Code:72756
Practice Address - Country:US
Practice Address - Phone:479-636-9495
Practice Address - Fax:479-636-9449
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-19
Last Update Date:2008-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR1595111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR5M380OtherCHIROPRACTOR
ARV008858Medicare UPIN
AR5M380Medicare ID - Type UnspecifiedCHIROPRACTOR