Provider Demographics
NPI:1982162103
Name:CORONA, CAITLIN HALEY (DC)
Entity Type:Individual
Prefix:
First Name:CAITLIN
Middle Name:HALEY
Last Name:CORONA
Suffix:
Gender:F
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 335
Mailing Address - Street 2:
Mailing Address - City:QUITMAN
Mailing Address - State:AR
Mailing Address - Zip Code:72131-0335
Mailing Address - Country:US
Mailing Address - Phone:501-589-2222
Mailing Address - Fax:501-589-2222
Practice Address - Street 1:5 NEW ST
Practice Address - Street 2:
Practice Address - City:QUITMAN
Practice Address - State:AR
Practice Address - Zip Code:72131-8607
Practice Address - Country:US
Practice Address - Phone:501-589-2222
Practice Address - Fax:501-589-2222
Is Sole Proprietor?:No
Enumeration Date:2019-03-06
Last Update Date:2019-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR16208111NI0013X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NI0013XChiropractic ProvidersChiropractorIndependent Medical Examiner