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General NPI Number Information
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NPI Number | 1528327921
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Entity Type | Organization
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Legal Business Name | LANCE HATCH
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Dates
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Enumeration Date | 05/07/2012
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Last Update Date | 03/24/2017
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Provider Practice Location Address
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Address Line | 1575 KISKER RD
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City | SAINT CHARLES
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State | MO
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Zip | 63304-0608
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Country | US
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Telephone | 636-922-4140
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Fax | 636-922-4113
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Provider Business Mailing Address
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Address Line | 1575 KISKER RD
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City | SAINT CHARLES
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State | MO
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Zip | 63304-0608
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Country | US
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Telephone | 636-922-4140
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Fax | 636-922-4113
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Authorized Official
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Title or Position | CHIROPRACTIC PHYSICIAN
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Name | DR. LANCE R. HATCH
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Credential | DC
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Telephone | 314-306-8086
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 2011022443
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License Number State | MO
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