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General NPI Number Information
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NPI Number | 1265768626
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Entity Type | Organization
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Legal Business Name | HAYNES FAMILY CHIROPRACTIC
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Dates
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Enumeration Date | 10/20/2009
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Last Update Date | 10/20/2009
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Provider Practice Location Address
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Address Line | 710 HATCHER LN
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City | COLUMBIA
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State | TN
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Zip | 38401-3522
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Country | US
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Telephone | 931-380-3001
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Fax | 931-380-3012
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Provider Business Mailing Address
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Address Line | 710 HATCHER LN
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City | COLUMBIA
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State | TN
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Zip | 38401-3522
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Country | US
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Telephone | 931-380-3001
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Fax | 931-380-3012
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Authorized Official
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Title or Position | SOLE PROPRIETOR
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Name | DR. LEWIS PHILLIP HAYNES
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Credential | D.C.
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Telephone | 931-380-3001
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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 | DC582
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | DC584
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License Number State | TN
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