Healthcare Provider Details

I. General information

NPI: 1467535286
Provider Name (Legal Business Name): GREG ALAN HAUSER DC, FICPA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/23/2006
Last Update Date: 07/10/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15810 S 45TH ST SUITE 160
PHOENIX AZ
85048-7694
US

IV. Provider business mailing address

15810 S 45TH ST SUITE 160
PHOENIX AZ
85048-7694
US

V. Phone/Fax

Practice location:
  • Phone: 480-704-6600
  • Fax: 480-704-6617
Mailing address:
  • Phone: 480-704-6600
  • Fax: 480-704-6617

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number7290
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License Number7290
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: