Healthcare Provider Details

I. General information

NPI: 1770525651
Provider Name (Legal Business Name): ROBERT WALTER HAUG D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/12/2006
Last Update Date: 10/02/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1466 RIVERSIDE DR STE C
CHATTANOOGA TN
37406-4323
US

IV. Provider business mailing address

1466 RIVERSIDE DR STE C
CHATTANOOGA TN
37406-4323
US

V. Phone/Fax

Practice location:
  • Phone: 423-643-2211
  • Fax: 423-643-2210
Mailing address:
  • Phone: 423-643-2211
  • Fax: 423-643-2210

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NN1001X
TaxonomyNutrition Chiropractor
License NumberDC0000001918
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: