Provider Demographics
NPI:1093214793
Name:HAVLIN, HANK
Entity Type:Individual
Prefix:
First Name:HANK
Middle Name:
Last Name:HAVLIN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4625 S EMERSON AVE
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46203-5972
Mailing Address - Country:US
Mailing Address - Phone:317-677-0202
Mailing Address - Fax:317-790-3659
Practice Address - Street 1:4625 S EMERSON AVE
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46203-5972
Practice Address - Country:US
Practice Address - Phone:317-667-0202
Practice Address - Fax:317-790-3659
Is Sole Proprietor?:No
Enumeration Date:2018-02-08
Last Update Date:2018-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist