Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NX0800X | Chiropractor Orthopedic Specialist | 1333 | AR |
NPI | 1326134156 |
---|---|
Provider Name | Dr. Evana Dion Pickett |
First Address | Pocahontas, AR 72455 |
Second Address | Pocahontas, AR 72455-1202 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/10/2006 |
Last Update Date | 08/07/2007 |