Provider Demographics
NPI:1134617848
Name:IGNITE CHIROPRACTIC PLLC
Entity type:Organization
Organization Name:IGNITE CHIROPRACTIC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER/CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:NATALIE
Authorized Official - Middle Name:M
Authorized Official - Last Name:HORINE
Authorized Official - Suffix:
Authorized Official - Credentials:DC, MS
Authorized Official - Phone:740-381-0818
Mailing Address - Street 1:4101 W HUNTINGTON DR APT 2308
Mailing Address - Street 2:
Mailing Address - City:ROGERS
Mailing Address - State:AR
Mailing Address - Zip Code:72758-4191
Mailing Address - Country:US
Mailing Address - Phone:740-381-0818
Mailing Address - Fax:
Practice Address - Street 1:4305 S PLEASANT CROSSING BLVD STE 102
Practice Address - Street 2:
Practice Address - City:ROGERS
Practice Address - State:AR
Practice Address - Zip Code:72758-1347
Practice Address - Country:US
Practice Address - Phone:405-771-0668
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-27
Last Update Date:2018-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ART16188111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty