Healthcare Provider Details

I. General information

NPI: 1003723818
Provider Name (Legal Business Name): HAVEN LEE HAAS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/26/2026
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

430 VICTORIA RD
NEWTON KS
67114-8746
US

IV. Provider business mailing address

816 FOX RIDGE ST
NEWTON KS
67114-9075
US

V. Phone/Fax

Practice location:
  • Phone: 316-804-7095
  • Fax:
Mailing address:
  • Phone: 816-745-0482
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number01-06504
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: