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General NPI Number Information
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NPI Number | 1437105798
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Entity Type | Organization
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Legal Business Name | BRIAN G HACKLEMAN DC
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Dates
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Enumeration Date | 05/26/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 800 E ALDRICH RD
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City | BOLIVAR
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State | MO
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Zip | 65613
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Country | US
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Telephone | 417-326-3527
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Fax | 417-326-3529
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Provider Business Mailing Address
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Address Line | 800 E ALDRICH RD
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City | BOLIVAR
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State | MO
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Zip | 65613
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Country | US
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Telephone | 417-326-3527
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Fax | 417-326-3529
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Authorized Official
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Title or Position | DOCTOR
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Name | BRIAN G HACKLEMAN
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Credential | DC
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Telephone | 417-326-3527
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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 | 006529
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License Number State | MO
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