Organization
NESTERENKO SPECIFIC CHIROPRACTIC, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PAUL ANTHONY NESTERENKO D.C. (CHIROPRACTOR/PRESIDENT)
(501) 223-5130
Entity
Organization
Contact information
Practice address
13601 W MARKHAM ST, LITTLE ROCK, AR 72211-3146
(501) 223-5130
Mailing address
13601 W MARKHAM ST, LITTLE ROCK, AR 72211-3146
(501) 223-5130
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1342
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5S657
BLUE CROSS BLUE SHIELD
AR
01
—
U46723
BLUE CROSS BLUE SHIELD
AR
Enumeration date
07/28/2008
Last updated
01/14/2016
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