Organization
WHITE RIVER CHIROPRACTIC LIFE CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THOMAS DEAN TAYLOR D.C. (PRESIDENT)
(870) 698-1650
Entity
Organization
Contact information
Practice address
1361 WHITE DR, BATESVILLE, AR 72501-9467
(870) 698-1650
(870) 793-4790
Mailing address
PO BOX 2544, BATESVILLE, AR 72503-2544
(870) 698-1650
(870) 793-4790
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
940
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
127932718
—
AR
01
—
5F871
MEDICARE PTAN (LEGACY NUMBER)
AR
Enumeration date
04/18/2007
Last updated
06/30/2008
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