Provider Demographics
NPI:1093211864
Name:HAGUE CHIROPRACTIC LLC
Entity Type:Organization
Organization Name:HAGUE CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SAMANTHA
Authorized Official - Middle Name:J
Authorized Official - Last Name:HAGUE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:712-249-9386
Mailing Address - Street 1:450 MEADOWS CT
Mailing Address - Street 2:
Mailing Address - City:CHENEY
Mailing Address - State:KS
Mailing Address - Zip Code:67025-7600
Mailing Address - Country:US
Mailing Address - Phone:316-542-1317
Mailing Address - Fax:
Practice Address - Street 1:450 MEADOWS CT
Practice Address - Street 2:
Practice Address - City:CHENEY
Practice Address - State:KS
Practice Address - Zip Code:67025-7600
Practice Address - Country:US
Practice Address - Phone:316-542-1317
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-02
Last Update Date:2018-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS01-05893111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty