Provider Demographics
NPI:1578971875
Name:BEARD, MERISSA (DC)
Entity Type:Individual
Prefix:DR
First Name:MERISSA
Middle Name:
Last Name:BEARD
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:MERISSA
Other - Middle Name:
Other - Last Name:BEARD
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC
Mailing Address - Street 1:2415 PRINCE ST
Mailing Address - Street 2:103
Mailing Address - City:CONWAY
Mailing Address - State:AR
Mailing Address - Zip Code:72034-3746
Mailing Address - Country:US
Mailing Address - Phone:501-504-6280
Mailing Address - Fax:501-504-6286
Practice Address - Street 1:2415 PRINCE ST
Practice Address - Street 2:103
Practice Address - City:CONWAY
Practice Address - State:AR
Practice Address - Zip Code:72034-3746
Practice Address - Country:US
Practice Address - Phone:501-504-6280
Practice Address - Fax:501-504-6286
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-30
Last Update Date:2020-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR16067111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor