Provider Demographics
NPI:1497905228
Name:SIMPKINS-SPAIN, VITA KRISTINA (DC)
Entity Type:Individual
Prefix:DR
First Name:VITA
Middle Name:KRISTINA
Last Name:SIMPKINS-SPAIN
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 1:7 EAST COLT SQUARE
Mailing Address - Street 2:SUITE 3
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72703
Mailing Address - Country:US
Mailing Address - Phone:479-521-9119
Mailing Address - Fax:479-521-1016
Practice Address - Street 1:7 EAST COLT SQUARE
Practice Address - Street 2:SUITE 3
Practice Address - City:FAYETTEVILLE
Practice Address - State:AR
Practice Address - Zip Code:72703
Practice Address - Country:US
Practice Address - Phone:479-521-9119
Practice Address - Fax:479-521-1016
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-29
Last Update Date:2015-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR1733111N00000X
TX10786111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor