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General NPI Number Information
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NPI Number | 1891916797
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Entity Type | Organization
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Legal Business Name | HAELY CHIROPRACTIC, INC.
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Dates
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Enumeration Date | 05/01/2007
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Last Update Date | 02/28/2012
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Provider Practice Location Address
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Address Line | 7500 TOWN CENTRE DR STE 300
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City | BROADVIEW HTS
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State | OH
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Zip | 44147-4009
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Country | US
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Telephone | 440-838-5755
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Fax | 440-838-5766
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Provider Business Mailing Address
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Address Line | 7500 TOWN CENTRE DR STE 300
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City | BROADVIEW HTS
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State | OH
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Zip | 44147-4009
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Country | US
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Telephone | 440-838-5755
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | RYAN M HAELY
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Credential | D.C.
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Telephone | 440-838-5755
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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 | OH3160
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License Number State | OH
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