Provider Demographics
NPI:1255758397
Name:INVISION FAMILY CHIROPRACTIC, LLC
Entity type:Organization
Organization Name:INVISION FAMILY CHIROPRACTIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:
Authorized Official - First Name:MELANIE
Authorized Official - Middle Name:D
Authorized Official - Last Name:GARTSIDE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:618-210-8571
Mailing Address - Street 1:1720 S WALTON BLVD STE 6
Mailing Address - Street 2:
Mailing Address - City:BENTONVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72712-7533
Mailing Address - Country:US
Mailing Address - Phone:479-464-0834
Mailing Address - Fax:479-464-0836
Practice Address - Street 1:1720 S WALTON BLVD STE 6
Practice Address - Street 2:
Practice Address - City:BENTONVILLE
Practice Address - State:AR
Practice Address - Zip Code:72712-7533
Practice Address - Country:US
Practice Address - Phone:479-464-0834
Practice Address - Fax:479-464-0836
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-26
Last Update Date:2014-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR16040111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty