Provider Demographics
NPI:1720287717
Name:BACHERT, DEANNA YRAGUI (DC)
Entity type:Individual
Prefix:DR
First Name:DEANNA
Middle Name:YRAGUI
Last Name:BACHERT
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2717 SE I STREET
Mailing Address - Street 2:STE. 7
Mailing Address - City:BENTONVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72712-3208
Mailing Address - Country:US
Mailing Address - Phone:479-273-7301
Mailing Address - Fax:479-273-7303
Practice Address - Street 1:2717 SE I ST
Practice Address - Street 2:STE. 7
Practice Address - City:BENTONVILLE
Practice Address - State:AR
Practice Address - Zip Code:72712-3996
Practice Address - Country:US
Practice Address - Phone:479-273-7301
Practice Address - Fax:479-273-7303
Is Sole Proprietor?:No
Enumeration Date:2007-07-11
Last Update Date:2012-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR1579111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR5W787Medicare UPIN