Individual
DR. ROBERT L SHACKELFORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
219 SW SECOND ST, WALNUT RIDGE, AR 72476-2335
(870) 886-2603
(870) 886-2623
Mailing address
219 SW SECOND ST, PO BOX 896, WALNUT RIDGE, AR 72476-2335
(870) 886-2603
(870) 886-2623
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
998
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
105133718
—
AR
Enumeration date
05/19/2006
Last updated
04/25/2014
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