Provider Demographics
NPI:1194212571
Name:HAMLETT FAMILY CHIROPRACTIC
Entity Type:Organization
Organization Name:HAMLETT FAMILY CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF CHIROPRACTIC
Authorized Official - Prefix:DR
Authorized Official - First Name:LACEY
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:HAMLETT
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:319-358-8999
Mailing Address - Street 1:850 22ND AVE STE 3
Mailing Address - Street 2:
Mailing Address - City:CORALVILLE
Mailing Address - State:IA
Mailing Address - Zip Code:52241-1688
Mailing Address - Country:US
Mailing Address - Phone:319-358-8999
Mailing Address - Fax:319-834-1128
Practice Address - Street 1:850 22ND AVE STE 3
Practice Address - Street 2:
Practice Address - City:CORALVILLE
Practice Address - State:IA
Practice Address - Zip Code:52241-1688
Practice Address - Country:US
Practice Address - Phone:319-358-8999
Practice Address - Fax:319-834-1128
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-20
Last Update Date:2018-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA087448111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty