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General NPI Number Information
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NPI Number | 1831393123
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Entity Type | Organization
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Legal Business Name | HASKINS CHIROPRACTIC CLINIC
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Dates
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Enumeration Date | 06/12/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2141 CASS LAKE RD SUITE 103
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City | KEEGO HARBOR
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State | MI
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Zip | 48320-1270
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Country | US
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Telephone | 248-462-5621
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Fax |
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Provider Business Mailing Address
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Address Line | 2141 CASS LAKE RD SUITE 103
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City | KEEGO HARBOR
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State | MI
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Zip | 48320-1270
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Country | US
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Telephone | 248-462-5621
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DENNIS HASKINS
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Credential | DC
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Telephone | 248-462-5621
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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 | DH004032
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License Number State | MI
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