Provider Demographics
NPI:1184812448
Name:CWMC OF SEARCY
Entity type:Organization
Organization Name:CWMC OF SEARCY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:BAINES
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:501-268-4101
Mailing Address - Street 1:303 E CENTER AVE
Mailing Address - Street 2:
Mailing Address - City:SEARCY
Mailing Address - State:AR
Mailing Address - Zip Code:72143-5403
Mailing Address - Country:US
Mailing Address - Phone:501-268-4101
Mailing Address - Fax:501-268-7710
Practice Address - Street 1:303 E CENTER AVE
Practice Address - Street 2:
Practice Address - City:SEARCY
Practice Address - State:AR
Practice Address - Zip Code:72143-5403
Practice Address - Country:US
Practice Address - Phone:501-268-4101
Practice Address - Fax:501-268-7710
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-11
Last Update Date:2007-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty