# WHITE RIVER CHIROPRACTIC LIFE CENTER, INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1770709321
- **Authorized official:** DR. THOMAS DEAN TAYLOR D.C. (PRESIDENT)
- **Authorized official phone:** (870) 698-1650

## Contact information

- **Practice address:** 1361 WHITE DR, BATESVILLE, AR 72501-9467
- **Practice address phone:** (870) 698-1650
- **Practice address fax:** (870) 793-4790
- **Mailing address:** PO BOX 2544, BATESVILLE, AR 72503-2544
- **Mailing address phone:** (870) 698-1650
- **Mailing address fax:** (870) 793-4790

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 111N00000X | Chiropractor | 940 | AR | Yes |

## Other

- **Enumeration date:** 04/18/2007
- **Last updated:** 06/30/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 127932718 | — | AR |
| 01 | — | 5F871 | MEDICARE PTAN (LEGACY NUMBER) | AR |