Provider Demographics
NPI:1104200211
Name:HAUCH, FREDERICK MORTON JR (DC)
Entity Type:Individual
Prefix:DR
First Name:FREDERICK
Middle Name:MORTON
Last Name:HAUCH
Suffix:JR
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 713
Mailing Address - Street 2:
Mailing Address - City:ADRIAN
Mailing Address - State:MI
Mailing Address - Zip Code:49221-0713
Mailing Address - Country:US
Mailing Address - Phone:517-265-3444
Mailing Address - Fax:517-265-3445
Practice Address - Street 1:231 N MAIN ST
Practice Address - Street 2:
Practice Address - City:ADRIAN
Practice Address - State:MI
Practice Address - Zip Code:49221-2712
Practice Address - Country:US
Practice Address - Phone:517-265-3444
Practice Address - Fax:517-265-3445
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-17
Last Update Date:2015-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301010251111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor