Provider Demographics
NPI:1588804603
Name:OUACHITA MANAGEMENT, INC.
Entity Type:Organization
Organization Name:OUACHITA MANAGEMENT, INC.
Other - Org Name:DAILEY CHIROPRACTIC CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CRAYTON
Authorized Official - Middle Name:DON
Authorized Official - Last Name:DAILEY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:501-984-9977
Mailing Address - Street 1:4501 N HIGHWAY 7
Mailing Address - Street 2:SUITE 2
Mailing Address - City:HOT SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:71909-9799
Mailing Address - Country:US
Mailing Address - Phone:501-984-9977
Mailing Address - Fax:501-984-9979
Practice Address - Street 1:4501 N HIGHWAY 7
Practice Address - Street 2:SUITE 2
Practice Address - City:HOT SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:71909-9799
Practice Address - Country:US
Practice Address - Phone:501-984-9977
Practice Address - Fax:501-984-9979
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-02
Last Update Date:2009-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR1650111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR5G179Medicare UPIN