(a) A licensed chiropractor who provides chiropractic
services in a location other than a registered chiropractic facility
(out-of-facility services) shall provide the board with a list that
contains the following information, for each location:
  (1) its name;
  (2) its address and telephone number;
  (3) the name of the owner or manager; and
  (4) the planned or actual number of visits per week.