Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NP0017X | Pediatric Chiropractor | 15642 | AR |
NPI | 1386978179 |
---|---|
Provider Name | Joshua R. Jones |
First Address | Bella Vista, AR 72715-8904 |
Second Address | Bentonville, AR 72712-6713 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/09/2009 |
Last Update Date | 25/09/2009 |