Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 16259 | AR |
NPI | 1003413857 |
---|---|
Provider Name | Abby Keener |
First Address | Fort Smith, AR 72903-4277 |
Second Address | Fort Smith, AR 72903-4277 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/10/2020 |
Last Update Date | 05/10/2020 |