Provider Demographics
NPI:1679597298
Name:SKINNER CHIROPRACTIC PLLC
Entity type:Organization
Organization Name:SKINNER CHIROPRACTIC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KYLE
Authorized Official - Middle Name:LEWIS
Authorized Official - Last Name:SKINNER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:501-851-6685
Mailing Address - Street 1:123 AUDUBON DR
Mailing Address - Street 2:SUTIE 700
Mailing Address - City:MAUMELLE
Mailing Address - State:AR
Mailing Address - Zip Code:72113-5806
Mailing Address - Country:US
Mailing Address - Phone:501-851-6685
Mailing Address - Fax:501-851-6685
Practice Address - Street 1:123 AUDUBON DR
Practice Address - Street 2:SUTIE 700
Practice Address - City:MAUMELLE
Practice Address - State:AR
Practice Address - Zip Code:72113-5806
Practice Address - Country:US
Practice Address - Phone:501-851-6685
Practice Address - Fax:501-851-6685
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR1660111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty