Healthcare Provider Details

I. General information

NPI: 1407916315
Provider Name (Legal Business Name): HARDWICK CHIROPRACTIC INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/11/2006
Last Update Date: 09/09/2021
Certification Date: 09/09/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

54 SCHOOL CIR
EAST HARDWICK VT
05836-9616
US

IV. Provider business mailing address

54 SCHOOL CIR
EAST HARDWICK VT
05836-9616
US

V. Phone/Fax

Practice location:
  • Phone: 802-472-3033
  • Fax: 802-472-3022
Mailing address:
  • Phone: 802-472-3033
  • Fax: 802-472-3022

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207PE0005X
TaxonomyUndersea and Hyperbaric Medicine (Emergency Medicine) Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2083P0011X
TaxonomyUndersea and Hyperbaric Medicine (Preventive Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: MORGAN S. BURKE
Title or Position: OFFICE MANAGER
Credential:
Phone: 802-472-3033