MEDICARE: DENNIS KEITH HASKINS DC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	DH004032	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0F33644	OTHER	MI	BCBS

General Provider Information

NPI Number	:	1851330161
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DENNIS KEITH HASKINS DC

Provider Business Mailing Address
First Line	:	2141 CASS LAKE ROAD
Second Line	:	SUITE 103
City	:	KEEGO HARBOR
State	:	MI
Zip	:	48320
Country	:	US
Telephone Number	:	248-462-5621
Fax Number	:

Provider Business Practice Location Address
First Line	:	2141 CASS LAKE RD
Second Line	:	SUITE 103
City	:	KEEGO HARBOR
State	:	MI
Zip	:	48320-1270
Country	:	US
Telephone Number	:	248-462-5621
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/05/2006
Last Update Date	:	07/15/2008

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Directions to “ DENNIS KEITH HASKINS DC” Practice Location

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