Provider Demographics
NPI:1801237169
Name:ADJUST FOR VITALITY CHIROPRACTIC & ACUPUNCTURE
Entity type:Organization
Organization Name:ADJUST FOR VITALITY CHIROPRACTIC & ACUPUNCTURE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:SHAUN
Authorized Official - Last Name:BARRY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:479-670-1438
Mailing Address - Street 1:300 NE MOBERLY LN
Mailing Address - Street 2:APT R10
Mailing Address - City:BENTONVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72712-6144
Mailing Address - Country:US
Mailing Address - Phone:479-670-1438
Mailing Address - Fax:
Practice Address - Street 1:1703 FOREST HILLS BLVD
Practice Address - Street 2:
Practice Address - City:BELLA VISTA
Practice Address - State:AR
Practice Address - Zip Code:72715-2340
Practice Address - Country:US
Practice Address - Phone:479-657-2112
Practice Address - Fax:479-657-2117
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-15
Last Update Date:2013-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2012028482111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Single Specialty