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NPI Code Detail

MEDICARE: HAGGARD CHIROPRACTIC II LLC

MEDICARE: HAGGARD CHIROPRACTIC II 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
1111N00000XChiropractor5421AZ

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2Z69376OTHERAZMEDICARE GROUP

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1AZ0934710OTHERAZAZBLS

General Provider Information

NPI Number : 1821260423
Entity Type Code : Organization
Provider Name (Legal Business Name) : HAGGARD CHIROPRACTIC II LLC
Provider Business Mailing Address
First Line : 8278 W LAKE PLEASANT PKWY STE 103
Second Line :
City : PEORIA
State : AZ
Zip : 85382-7441
Country : US
Telephone Number : 623-322-1925
Fax Number : 201-246-6678
Provider Business Practice Location Address
First Line : 8278 W LAKE PLEASANT PKWY STE 103
Second Line :
City : PEORIA
State : AZ
Zip : 85382-7441
Country : US
Telephone Number : 623-322-1925
Fax Number : 201-246-6678
Authorized Official
Title or Position : CA
Name : CHARITY HAGGARD
Credential :
Telephone Number : 623-322-1925
Provider Enumeration Date : 03/24/2008
Last Update Date : 03/23/2023

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Directions to “HAGGARD CHIROPRACTIC II LLC ” Practice Location

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