Organization
ELITE SPINE & JOINT, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN DYLAN MACHYCEK DC (OWNER)
(501) 653-2225
Entity
Organization
Contact information
Practice address
3309 WINCHESTER, BENTON, AR 72015-2896
(501) 575-0271
(501) 575-0274
Mailing address
3309 WINCHESTER, BENTON, AR 72015-2896
(501) 575-0271
(501) 575-0274
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
16155
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
16155
CHIROPRACTIC LICENSE NO.
AR
Enumeration date
05/02/2017
Last updated
07/21/2022
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