Provider Demographics
NPI:1114373875
Name:LUCIUS, HAYLEY
Entity Type:Individual
Prefix:
First Name:HAYLEY
Middle Name:
Last Name:LUCIUS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8855 HYPOLUXO RD
Mailing Address - Street 2:SUIT C-11
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33467-5250
Mailing Address - Country:US
Mailing Address - Phone:561-275-2525
Mailing Address - Fax:
Practice Address - Street 1:306 N BARNARD ST
Practice Address - Street 2:
Practice Address - City:HOWELL
Practice Address - State:MI
Practice Address - Zip Code:48843-1878
Practice Address - Country:US
Practice Address - Phone:517-225-5126
Practice Address - Fax:517-375-6544
Is Sole Proprietor?:No
Enumeration Date:2016-05-11
Last Update Date:2023-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH 11839111N00000X
MI2301401285111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor