Provider Demographics
NPI:1720302268
Name:POWELL FAMILY CHIROPRACTIC, PLLC
Entity Type:Organization
Organization Name:POWELL FAMILY CHIROPRACTIC, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:FLOYD
Authorized Official - Middle Name:
Authorized Official - Last Name:POWELL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:479-301-8026
Mailing Address - Street 1:1399 WILLARD ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGDALE
Mailing Address - State:AR
Mailing Address - Zip Code:72762-6097
Mailing Address - Country:US
Mailing Address - Phone:479-756-9355
Mailing Address - Fax:479-756-9354
Practice Address - Street 1:1399 WILLARD ST
Practice Address - Street 2:
Practice Address - City:SPRINGDALE
Practice Address - State:AR
Practice Address - Zip Code:72762-6097
Practice Address - Country:US
Practice Address - Phone:479-756-9355
Practice Address - Fax:479-756-9354
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-25
Last Update Date:2010-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR15705111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty