Provider Demographics
NPI:1679529770
Name:CHENAL CHIROPRACTIC CLINIC, PLLC
Entity type:Organization
Organization Name:CHENAL CHIROPRACTIC CLINIC, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PATNER
Authorized Official - Prefix:
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:R
Authorized Official - Last Name:SKINNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:315-480-5729
Mailing Address - Street 1:17200 CHENAL PKWY
Mailing Address - Street 2:SUITE 170
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72223-5958
Mailing Address - Country:US
Mailing Address - Phone:315-480-5729
Mailing Address - Fax:
Practice Address - Street 1:17200 CHENAL PKWY
Practice Address - Street 2:SUITE 170
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72223-5958
Practice Address - Country:US
Practice Address - Phone:315-480-5729
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty