Provider Demographics
NPI:1285951616
Name:POYNOR CHIROPRACTIC AND REHABILITATION
Entity type:Organization
Organization Name:POYNOR CHIROPRACTIC AND REHABILITATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:POYNOR
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:870-236-9876
Mailing Address - Street 1:1906 MOCKINGBIRD LN
Mailing Address - Street 2:SUITE B
Mailing Address - City:PARAGOULD
Mailing Address - State:AR
Mailing Address - Zip Code:72450-5806
Mailing Address - Country:US
Mailing Address - Phone:870-236-9876
Mailing Address - Fax:870-236-9879
Practice Address - Street 1:1906 MOCKINGBIRD LN
Practice Address - Street 2:SUITE B
Practice Address - City:PARAGOULD
Practice Address - State:AR
Practice Address - Zip Code:72450-5806
Practice Address - Country:US
Practice Address - Phone:870-236-9876
Practice Address - Fax:870-236-9879
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-25
Last Update Date:2010-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR15695111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty