Organization
MAGNOLIA HEALTH CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RAYMOND T DURHAM D.C. (OWNER)
(870) 234-8800
Entity
Organization
Contact information
Practice address
205 W MAIN ST, MAGNOLIA, AR 71753-3518
(870) 234-8800
(870) 234-8801
Mailing address
205 W MAIN ST, MAGNOLIA, AR 71753-3518
(870) 234-8800
(870) 234-8801
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
15693
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1386647774
INDIVIDUAL NPI
AR
01
—
5605574
AETNA
AR
Enumeration date
03/18/2009
Last updated
03/18/2009
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