Provider Demographics
NPI:1689607723
Name:RACHEOTES, ALEXIS (DC)
Entity Type:Individual
Prefix:DR
First Name:ALEXIS
Middle Name:
Last Name:RACHEOTES
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 1:3538 N HWY 112
Mailing Address - Street 2:STE 2
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72704-6093
Mailing Address - Country:US
Mailing Address - Phone:479-443-9699
Mailing Address - Fax:
Practice Address - Street 1:3538 N HWY 112
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:AR
Practice Address - Zip Code:72704-6093
Practice Address - Country:US
Practice Address - Phone:479-443-9699
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-09
Last Update Date:2009-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR1633111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR5Y129OtherABCBS
AR5Y129OtherABCBS