Provider Demographics
NPI:1003393372
Name:COREY G. HAHN, D.C. LLC
Entity Type:Organization
Organization Name:COREY G. HAHN, D.C. LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:COREY
Authorized Official - Middle Name:G
Authorized Official - Last Name:HAHN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:636-778-2574
Mailing Address - Street 1:141 CHESTERFIELD BUSINESS PKWY
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:63005-1233
Mailing Address - Country:US
Mailing Address - Phone:636-778-2574
Mailing Address - Fax:636-778-2573
Practice Address - Street 1:141 CHESTERFIELD BUSINESS PKWY
Practice Address - Street 2:
Practice Address - City:CHESTERFIELD
Practice Address - State:MO
Practice Address - Zip Code:63005-1233
Practice Address - Country:US
Practice Address - Phone:636-778-2574
Practice Address - Fax:636-778-2573
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-19
Last Update Date:2018-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2014032317111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty