Provider Demographics
NPI:1255814984
Name:FORTE, RICHARD JR (DC)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:
Last Name:FORTE
Suffix:JR
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1008 NW J ST STE J
Mailing Address - Street 2:
Mailing Address - City:BENTONVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72712-4103
Mailing Address - Country:US
Mailing Address - Phone:470-219-0052
Mailing Address - Fax:
Practice Address - Street 1:1008 NW J ST STE J
Practice Address - Street 2:
Practice Address - City:BENTONVILLE
Practice Address - State:AR
Practice Address - Zip Code:72712-4103
Practice Address - Country:US
Practice Address - Phone:479-412-4121
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-10
Last Update Date:2024-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC011387111N00000X
COCHR.0007894111N00000X
AR16427111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty