Provider Demographics
NPI:1881652345
Name:KENT, DANNY HANDFORD (DC)
Entity Type:Individual
Prefix:
First Name:DANNY
Middle Name:HANDFORD
Last Name:KENT
Suffix:
Gender:M
Credentials:DC
Other - Prefix:DR
Other - First Name:DAN
Other - Middle Name:H
Other - Last Name:KENT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC
Mailing Address - Street 1:PO BOX 683
Mailing Address - Street 2:3246 HWY 67 NORTH
Mailing Address - City:WALNUT RIDGE
Mailing Address - State:AR
Mailing Address - Zip Code:72476-0683
Mailing Address - Country:US
Mailing Address - Phone:870-886-2999
Mailing Address - Fax:870-886-2999
Practice Address - Street 1:3246 HIGHWAY 67
Practice Address - Street 2:
Practice Address - City:WALNUT RIDGE
Practice Address - State:AR
Practice Address - Zip Code:72476-8441
Practice Address - Country:US
Practice Address - Phone:870-886-2999
Practice Address - Fax:870-886-2999
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR879111NX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NX0800XChiropractic ProvidersChiropractorOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR59488OtherBLUE CROSS/BLUE SHIELD
AR59488Medicare UPIN
AR59488OtherBLUE CROSS/BLUE SHIELD