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General NPI Number Information
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NPI Number | 1285882845
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Entity Type | Organization
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Legal Business Name | HAGGERTY CHIROPRACTIC
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Dates
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Enumeration Date | 09/08/2008
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Last Update Date | 09/09/2008
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Provider Practice Location Address
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Address Line | 9757 FAIRWAY BLVD
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City | POWELL
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State | OH
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Zip | 43065-6947
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Country | US
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Telephone | 614-793-4653
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Fax | 614-793-0045
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Provider Business Mailing Address
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Address Line | 9757 FAIRWAY BLVD
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City | POWELL
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State | OH
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Zip | 43065-6947
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CHIROPRACTIC PHYSICIAN
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Name | JOHNATHAN HAGGERTY
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Credential |
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Telephone | 614-793-4653
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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 | 3905
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License Number State | OH
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