Provider Demographics
NPI:1144337346
Name:ENGELHOVEN, PEGGY SUE (DC)
Entity type:Individual
Prefix:DR
First Name:PEGGY
Middle Name:SUE
Last Name:ENGELHOVEN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4401 NORTH ORANGE STREET
Mailing Address - Street 2:
Mailing Address - City:NORTH LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72118
Mailing Address - Country:US
Mailing Address - Phone:501-753-6034
Mailing Address - Fax:501-753-1487
Practice Address - Street 1:4401 ORANGE ST
Practice Address - Street 2:
Practice Address - City:NORTH LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72118-3621
Practice Address - Country:US
Practice Address - Phone:501-753-6034
Practice Address - Fax:501-753-1487
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR985111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
ART20596Medicare UPIN