Provider Demographics
NPI:1588156590
Name:POOLE, DANIELLE FAITH (DC)
Entity type:Individual
Prefix:DR
First Name:DANIELLE
Middle Name:FAITH
Last Name:POOLE
Suffix:
Gender:
Credentials:DC
Other - Prefix:
Other - First Name:DANIELLE
Other - Middle Name:
Other - Last Name:LONG, CRAIG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4119 STADIUM BLVD
Mailing Address - Street 2:SUITE H
Mailing Address - City:JONESBORO
Mailing Address - State:AR
Mailing Address - Zip Code:72404
Mailing Address - Country:US
Mailing Address - Phone:870-277-2541
Mailing Address - Fax:
Practice Address - Street 1:4119 STADIUM BLVD STE H
Practice Address - Street 2:
Practice Address - City:JONESBORO
Practice Address - State:AR
Practice Address - Zip Code:72404-9465
Practice Address - Country:US
Practice Address - Phone:870-277-2541
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-05
Last Update Date:2025-03-27
Deactivation Date:2022-04-19
Deactivation Code:
Reactivation Date:2022-06-02
Provider Licenses
StateLicense IDTaxonomies
AR16339111N00000X, 111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor