Provider Demographics
NPI:1831464759
Name:ROOT'S CHIROPRACTIC
Entity Type:Organization
Organization Name:ROOT'S CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JUSTIN
Authorized Official - Middle Name:KYLER
Authorized Official - Last Name:POMEROY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:501-625-3446
Mailing Address - Street 1:1419 CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:HOT SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:71901-6149
Mailing Address - Country:US
Mailing Address - Phone:501-625-2446
Mailing Address - Fax:501-625-3448
Practice Address - Street 1:1403 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:HOT SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:71901-6149
Practice Address - Country:US
Practice Address - Phone:501-625-3446
Practice Address - Fax:501-762-0310
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-09
Last Update Date:2018-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR15939261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty