Provider Demographics
NPI:1285953638
Name:CHIROWEST PA
Entity type:Organization
Organization Name:CHIROWEST PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRIS
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:CULPEPPER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:501-319-2633
Mailing Address - Street 1:1203 S UNIVERSITY AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72204-2601
Mailing Address - Country:US
Mailing Address - Phone:501-296-9595
Mailing Address - Fax:501-296-9597
Practice Address - Street 1:1203 S UNIVERSITY AVE
Practice Address - Street 2:SUITE A
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72204-2601
Practice Address - Country:US
Practice Address - Phone:501-296-9595
Practice Address - Fax:501-296-9597
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-25
Last Update Date:2010-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR1365305S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service