Provider Demographics
NPI:1710426648
Name:DOLE, CHRIS (BS)
Entity Type:Individual
Prefix:
First Name:CHRIS
Middle Name:
Last Name:DOLE
Suffix:
Gender:M
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2800 S 2ND ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:CABOT
Mailing Address - State:AR
Mailing Address - Zip Code:72023-7025
Mailing Address - Country:US
Mailing Address - Phone:501-606-1463
Mailing Address - Fax:
Practice Address - Street 1:2800 S 2ND ST
Practice Address - Street 2:SUITE B
Practice Address - City:CABOT
Practice Address - State:AR
Practice Address - Zip Code:72023-7025
Practice Address - Country:US
Practice Address - Phone:501-606-1463
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-12
Last Update Date:2017-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist