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General NPI Number Information
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NPI Number | 1689530305
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Entity Type | Organization
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Legal Business Name | HAVEN CHIROPRACTIC AND WELLNESS CO
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Dates
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Enumeration Date | 12/26/2025
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Last Update Date | 12/26/2025
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Provider Practice Location Address
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Address Line | 11320 KINGSTON PIKE STE 102
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City | FARRAGUT
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State | TN
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Zip | 37934-2858
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Country | US
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Telephone | 920-840-4027
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Fax |
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Provider Business Mailing Address
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Address Line | 11320 KINGSTON PIKE STE 102
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City | FARRAGUT
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State | TN
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Zip | 37934-2858
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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 | OWNER
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Name | COLIN HICKEY
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Credential | D.C.
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Telephone | 920-840-4027
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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 |
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License Number State |
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