MEDICARE: HAWKINS HEALTH CENTER OF FRENCH LICK, LLC

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

General Provider Information

NPI Number	:	1588201057
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HAWKINS HEALTH CENTER OF FRENCH LICK, LLC

Provider Business Mailing Address
First Line	:	1 LOOGOOTEE PLZ
Second Line	:
City	:	LOOGOOTEE
State	:	IN
Zip	:	47553-5757
Country	:	US
Telephone Number	:	812-295-3346
Fax Number	:	812-295-4489

Provider Business Practice Location Address
First Line	:	8163 W STATE ROAD 56
Second Line	:
City	:	WEST BADEN SPRINGS
State	:	IN
Zip	:	47469-7706
Country	:	US
Telephone Number	:	812-295-3346
Fax Number	:	812-295-4489

Authorized Official
Title or Position	:	CHIROPRACTOR/OWNER
Name	:	DR. LESLIE B HAWKINS
Credential	:	DC
Telephone Number	:	812-295-3346

Provider Enumeration Date	:	12/04/2019
Last Update Date	:	12/04/2019

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