Organization
GEORGE CHIROPRACTIC CLINIC INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KENNETH DEWAYNE GEORGE D.C. (DOCTOR OWNER)
(870) 238-8707
Entity
Organization
Contact information
Practice address
1718 N FALLS BLVD, WYNNE, AR 72396-0498
(870) 238-8707
(870) 238-8711
Mailing address
PO BOX 498, 1718 N FALLS BLVD, WYNNE, AR 72396-0498
(870) 238-8707
(870) 238-8711
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
1452
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5T670
BLUE CROSS AND BLUE SHIEL
AR
Enumeration date
10/17/2006
Last updated
08/22/2020
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