Provider Demographics
NPI:1396016580
Name:HARDIN, ERIK E (LAC)
Entity Type:Individual
Prefix:
First Name:ERIK
Middle Name:E
Last Name:HARDIN
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:907 OAK MDW
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN HOME
Mailing Address - State:AR
Mailing Address - Zip Code:72653-4941
Mailing Address - Country:US
Mailing Address - Phone:870-421-4368
Mailing Address - Fax:
Practice Address - Street 1:505 S MAIN ST
Practice Address - Street 2:
Practice Address - City:MOUNTAIN HOME
Practice Address - State:AR
Practice Address - Zip Code:72653-3841
Practice Address - Country:US
Practice Address - Phone:870-421-4368
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-19
Last Update Date:2012-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARL.AC.059171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist