Provider Demographics
NPI:1841235249
Name:SANTOS, ERIC BRIAN (DC)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:BRIAN
Last Name:SANTOS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3333 S PINNACLE HILLS PKWY STE 430
Mailing Address - Street 2:
Mailing Address - City:ROGERS
Mailing Address - State:AR
Mailing Address - Zip Code:72758-9091
Mailing Address - Country:US
Mailing Address - Phone:479-464-4413
Mailing Address - Fax:479-464-4430
Practice Address - Street 1:1706 SE WALTON BLVD
Practice Address - Street 2:STE. 6
Practice Address - City:BENTONVILLE
Practice Address - State:AR
Practice Address - Zip Code:72712-3200
Practice Address - Country:US
Practice Address - Phone:479-464-4413
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-19
Last Update Date:2022-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR1675111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR5G474Medicare PIN
AR5Y800Medicare PIN