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General NPI Number Information
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NPI Number | 1952580672
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Entity Type | Organization
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Legal Business Name | HAZEN CHIROPRACTIC HEALTH CENTER INC.
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Dates
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Enumeration Date | 10/30/2007
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Last Update Date | 10/30/2007
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Provider Practice Location Address
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Address Line | 2932 S RICHARDS AVE
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City | SANTA FE
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State | NM
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Zip | 87507-5986
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Country | US
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Telephone | 505-473-0000
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Fax | 505-473-5315
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Provider Business Mailing Address
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Address Line | 2932 S RICHARDS AVE
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City | SANTA FE
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State | NM
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Zip | 87507-5986
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Country | US
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Telephone | 505-473-0000
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Fax | 505-473-5315
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Authorized Official
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Title or Position | OWNER
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Name | STEPHEN H HAZEN
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Credential | DC
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Telephone | 505-473-0000
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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 | 783
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License Number State | NM
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