Provider Demographics
NPI:1427130053
Name:BACHERT FAMILY CHIROPRACTIC
Entity type:Organization
Organization Name:BACHERT FAMILY CHIROPRACTIC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DEANNA
Authorized Official - Middle Name:Y
Authorized Official - Last Name:BACHERT
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:479-631-7300
Mailing Address - Street 1:1110 W POPLAR ST
Mailing Address - Street 2:STE B
Mailing Address - City:ROGERS
Mailing Address - State:AR
Mailing Address - Zip Code:72756
Mailing Address - Country:US
Mailing Address - Phone:479-631-7300
Mailing Address - Fax:479-631-7306
Practice Address - Street 1:1110 W POPLAR ST
Practice Address - Street 2:STE B
Practice Address - City:ROGERS
Practice Address - State:AR
Practice Address - Zip Code:72756
Practice Address - Country:US
Practice Address - Phone:479-631-7300
Practice Address - Fax:479-631-7306
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-20
Last Update Date:2012-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR1579111N00000X
AR1580111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
U95610Medicare UPIN
U97013Medicare UPIN
5C593Medicare ID - Type Unspecified