Healthcare Provider Details
I. General information
NPI: 1225077480
Provider Name (Legal Business Name): MICHAEL JOHN HACZELA D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 06/05/2006
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
274 3RD ST
BEAVER PA
15009-2363
US
IV. Provider business mailing address
274 3RD ST
BEAVER PA
15009-2363
US
V. Phone/Fax
- Phone: 724-775-1214
- Fax: 724-775-5262
- Phone: 724-775-1214
- Fax: 724-775-5262
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 111NS0005X |
| Taxonomy | Sports Physician Chiropractor |
| License Number | DC-007439-L |
| License Number State | PA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: