# ACTIVE LIFE ACUPUNCTURE & WELLNESS CENTER

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

## Provider details

- **NPI number:** 1851805493
- **Authorized official:** HAYDEN HENNINGSEN (OWNER/PRACTITIONER)
- **Authorized official phone:** (479) 358-7690

## Contact information

- **Practice address:** 2592 N GREGG AVE STE 10, FAYETTEVILLE, AR 72703-5520
- **Practice address phone:** (479) 358-7690
- **Mailing address:** 2592 N GREGG AVE STE 10, FAYETTEVILLE, AR 72703-5520

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 171100000X | Acupuncturist | 065 | AR | Yes |

## Other

- **Enumeration date:** 11/17/2017
- **Last updated:** 11/17/2017