MEDICARE: DR. HAILEY AXBERG DC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	CHI-CHI-6737	MT

General Provider Information

NPI Number	:	1437744406
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HAILEY AXBERG DC

Provider Business Mailing Address
First Line	:	2165 9TH ST W UNIT 4
Second Line	:
City	:	COLUMBIA FALLS
State	:	MT
Zip	:	59912-4561
Country	:	US
Telephone Number	:	406-219-8305
Fax Number	:

Provider Business Practice Location Address
First Line	:	2165 9TH ST W UNIT 4
Second Line	:
City	:	COLUMBIA FALLS
State	:	MT
Zip	:	59912-4561
Country	:	US
Telephone Number	:	406-219-8305
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/02/2021
Last Update Date	:	03/02/2021

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Directions to “ DR. HAILEY AXBERG DC” Practice Location

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