Provider Demographics
NPI:1356751978
Name:OSOWSKI, ALAN LEO (DC)
Entity type:Individual
Prefix:DR
First Name:ALAN
Middle Name:LEO
Last Name:OSOWSKI
Suffix:
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:PO BOX 5322
Mailing Address - Street 2:
Mailing Address - City:FORT SMITH
Mailing Address - State:AR
Mailing Address - Zip Code:72913-5322
Mailing Address - Country:US
Mailing Address - Phone:479-785-0400
Mailing Address - Fax:479-785-3620
Practice Address - Street 1:240 8 S. 51ST CT
Practice Address - Street 2:SUITE G
Practice Address - City:FORT SMITH
Practice Address - State:AR
Practice Address - Zip Code:72903-3422
Practice Address - Country:US
Practice Address - Phone:479-785-0400
Practice Address - Fax:479-785-3620
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-05
Last Update Date:2014-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR1237111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor