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General NPI Number Information
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NPI Number | 1639560311
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Entity Type | Organization
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Legal Business Name | HASLETT CHIROPRACTIC AND ACUPUNCTURE
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Dates
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Enumeration Date | 02/17/2015
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Last Update Date | 02/17/2015
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Provider Practice Location Address
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Address Line | 1375 S LAFAYETTE ST
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City | FLORISSANT
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State | MO
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Zip | 63031-7907
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Country | US
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Telephone | 314-306-8782
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Fax |
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Provider Business Mailing Address
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Address Line | 1375 S LAFAYETTE ST
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City | FLORISSANT
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State | MO
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Zip | 63031-7907
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Country | US
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Telephone | 314-306-8782
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Fax |
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Authorized Official
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Title or Position | OWNER/PROVIDER
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Name | CHRISTOPHER A HASLETT
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Credential | DC
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Telephone | 314-306-8782
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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 | 2014040733
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License Number State | MO
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