Healthcare Provider Details

I. General information

NPI: 1760534960
Provider Name (Legal Business Name): HARRY L HADLEY JR. DC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/17/2007
Last Update Date: 09/17/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6440 ALPINE AVE NW SUITE 2
COMSTOCK PARK MI
49321-8002
US

IV. Provider business mailing address

6440 ALPINE AVE NW SUITE 2
COMSTOCK PARK MI
49321-8002
US

V. Phone/Fax

Practice location:
  • Phone: 616-419-3399
  • Fax: 616-419-3371
Mailing address:
  • Phone: 616-419-3399
  • Fax: 616-419-3371

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111NX0800X
TaxonomyOrthopedic Chiropractor
License Number2301007976
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2301007976
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: