Provider Demographics
NPI:1811391451
Name:ACRIDGE CHIROPRACTIC PA
Entity Type:Organization
Organization Name:ACRIDGE CHIROPRACTIC PA
Other - Org Name:LOWELL CHIROPRACTIC AND HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/ CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:ACRIDGE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:479-770-0022
Mailing Address - Street 1:117 S DIXIELAND ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:LOWELL
Mailing Address - State:AR
Mailing Address - Zip Code:72745-8655
Mailing Address - Country:US
Mailing Address - Phone:479-770-0022
Mailing Address - Fax:479-770-0093
Practice Address - Street 1:117 S DIXIELAND ST
Practice Address - Street 2:SUITE B
Practice Address - City:LOWELL
Practice Address - State:AR
Practice Address - Zip Code:72745-8655
Practice Address - Country:US
Practice Address - Phone:479-770-0022
Practice Address - Fax:479-770-0093
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-10
Last Update Date:2014-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR15928111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty