Provider Demographics
NPI:1134870744
Name:ARCHWAY CHIROPRACTIC HEALTH INC
Entity type:Organization
Organization Name:ARCHWAY CHIROPRACTIC HEALTH INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INCORPORATOR/ORGANIZER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:TERRY
Authorized Official - Last Name:KERBS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:479-754-2500
Mailing Address - Street 1:1130 S ROGERS ST
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72830-9157
Mailing Address - Country:US
Mailing Address - Phone:479-754-2500
Mailing Address - Fax:479-754-3187
Practice Address - Street 1:1130 S ROGERS ST
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:AR
Practice Address - Zip Code:72830-9157
Practice Address - Country:US
Practice Address - Phone:479-754-2500
Practice Address - Fax:479-754-3187
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-14
Last Update Date:2022-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR5W153OtherBCBS
AR165759718Medicaid