Provider Demographics
NPI:1942561568
Name:VO ACUPUNCTURE & CHIROPRACTIC, LLC
Entity Type:Organization
Organization Name:VO ACUPUNCTURE & CHIROPRACTIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:
Authorized Official - Last Name:VO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:479-926-2789
Mailing Address - Street 1:12613 MARBLE DR
Mailing Address - Street 2:
Mailing Address - City:FORT SMITH
Mailing Address - State:AR
Mailing Address - Zip Code:72916-4150
Mailing Address - Country:US
Mailing Address - Phone:479-926-2789
Mailing Address - Fax:479-424-6715
Practice Address - Street 1:12613 MARBLE DR
Practice Address - Street 2:
Practice Address - City:FORT SMITH
Practice Address - State:AR
Practice Address - Zip Code:72916-4150
Practice Address - Country:US
Practice Address - Phone:479-926-2789
Practice Address - Fax:479-424-6715
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-30
Last Update Date:2012-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR15699111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR5H460Medicare UPIN