Provider Demographics
NPI:1194026658
Name:DR JOHN HAYDEN DC PA
Entity Type:Organization
Organization Name:DR JOHN HAYDEN DC PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESEDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:R
Authorized Official - Last Name:HAYDEN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:563-499-7114
Mailing Address - Street 1:235 APOLLO BEACH BLVD
Mailing Address - Street 2:SUITE 329
Mailing Address - City:APOLLO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33572-2251
Mailing Address - Country:US
Mailing Address - Phone:813-641-3333
Mailing Address - Fax:813-641-0843
Practice Address - Street 1:100 FRANDSON CT
Practice Address - Street 2:SUITE 101
Practice Address - City:APOLLO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33572-2659
Practice Address - Country:US
Practice Address - Phone:813-641-3333
Practice Address - Fax:813-641-0843
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-15
Last Update Date:2010-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH9795111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty