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General NPI Number Information
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NPI Number | 1194212571
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Entity Type | Organization
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Legal Business Name | HAMLETT FAMILY CHIROPRACTIC
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Dates
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Enumeration Date | 04/20/2018
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Last Update Date | 04/20/2018
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Provider Practice Location Address
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Address Line | 850 22ND AVE STE 3
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City | CORALVILLE
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State | IA
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Zip | 52241-1688
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Country | US
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Telephone | 319-358-8999
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Fax | 319-834-1128
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Provider Business Mailing Address
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Address Line | 850 22ND AVE STE 3
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City | CORALVILLE
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State | IA
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Zip | 52241-1688
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Country | US
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Telephone | 319-358-8999
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Fax | 319-834-1128
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Authorized Official
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Title or Position | DOCTOR OF CHIROPRACTIC
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Name | DR. LACEY ANN HAMLETT
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Credential | DC
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Telephone | 319-358-8999
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 087448
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License Number State | IA
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