Provider Demographics
NPI:1639684780
Name:EASTARK ONE PLLC
Entity Type:Organization
Organization Name:EASTARK ONE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:CATHEY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:501-716-9999
Mailing Address - Street 1:6801 W 12TH ST STE E
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72204-2466
Mailing Address - Country:US
Mailing Address - Phone:501-408-3806
Mailing Address - Fax:
Practice Address - Street 1:307 N WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:FORREST CITY
Practice Address - State:AR
Practice Address - Zip Code:72335-3356
Practice Address - Country:US
Practice Address - Phone:870-633-1076
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-12
Last Update Date:2017-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty