Provider Demographics
NPI:1780805168
Name:NOTTO CHIROPRACTIC HEALTH CENTER, INC.
Entity type:Organization
Organization Name:NOTTO CHIROPRACTIC HEALTH CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LEONARD NOTTO
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:NOTTO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:479-858-7176
Mailing Address - Street 1:619 E PARKWAY DR
Mailing Address - Street 2:
Mailing Address - City:RUSSELLVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72801-4106
Mailing Address - Country:US
Mailing Address - Phone:479-858-7176
Mailing Address - Fax:479-858-7176
Practice Address - Street 1:619 E PARKWAY DR
Practice Address - Street 2:
Practice Address - City:RUSSELLVILLE
Practice Address - State:AR
Practice Address - Zip Code:72801-4106
Practice Address - Country:US
Practice Address - Phone:479-858-7176
Practice Address - Fax:479-858-7176
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR1422111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR5T437OtherBCBS
AR5803430OtherAETNA
AR5T437Medicare ID - Type Unspecified
AR5803430OtherAETNA