Provider Demographics
NPI:1649459512
Name:HARRAH FAMILY CHIROPRACTIC CLINIC
Entity type:Organization
Organization Name:HARRAH FAMILY CHIROPRACTIC CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:D
Authorized Official - Last Name:HARRAH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:870-933-9085
Mailing Address - Street 1:PO BOX 16841
Mailing Address - Street 2:
Mailing Address - City:JONESBORO
Mailing Address - State:AR
Mailing Address - Zip Code:72403-6714
Mailing Address - Country:US
Mailing Address - Phone:870-933-9085
Mailing Address - Fax:870-933-9154
Practice Address - Street 1:1007 WINDOVER RD STE C
Practice Address - Street 2:
Practice Address - City:JONESBORO
Practice Address - State:AR
Practice Address - Zip Code:72401-6009
Practice Address - Country:US
Practice Address - Phone:870-933-9085
Practice Address - Fax:870-933-9154
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-29
Last Update Date:2007-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR1323261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center