Provider Demographics
NPI:1871591057
Name:WEEKS, LARRY C (DC)
Entity type:Individual
Prefix:DR
First Name:LARRY
Middle Name:C
Last Name:WEEKS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2618 W MLK JR. BLVD.
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72701-7698
Mailing Address - Country:US
Mailing Address - Phone:479-521-7755
Mailing Address - Fax:479-521-6965
Practice Address - Street 1:2618 W MLK JR. BLVD.
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:AR
Practice Address - Zip Code:72701-7698
Practice Address - Country:US
Practice Address - Phone:479-521-7755
Practice Address - Fax:479-521-6965
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-12
Last Update Date:2011-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR1218111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR119181718Medicaid
AR119181718Medicaid