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NPI Code Detail

MEDICARE: MARK J HAYNES A PROFESSIONAL CHIROPRACTIC CORPORATION

MEDICARE: MARK J HAYNES A PROFESSIONAL CHIROPRACTIC CORPORATION
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
1111N00000XChiropractor1115MT

General Provider Information

NPI Number : 1720132228
Entity Type Code : Organization
Provider Name (Legal Business Name) : MARK J HAYNES A PROFESSIONAL CHIROPRACTIC CORPORATION
Provider Business Mailing Address
First Line : 670 KING PARK DR
Second Line : STE 1
City : BILLINGS
State : MT
Zip : 59102-6257
Country : US
Telephone Number : 406-655-4940
Fax Number : 406-655-4944
Provider Business Practice Location Address
First Line : 670 KING PARK DR
Second Line : STE 1
City : BILLINGS
State : MT
Zip : 59102-6257
Country : US
Telephone Number : 406-655-4940
Fax Number : 406-655-4944
Authorized Official
Title or Position : OWNERPRESIDENT
Name : DR. MARK JONATHAN HAYNES
Credential : D.C.
Telephone Number : 406-655-4940
Provider Enumeration Date : 01/22/2007
Last Update Date : 02/23/2012

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Directions to “MARK J HAYNES A PROFESSIONAL CHIROPRACTIC CORPORATION ” Practice Location

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