Provider Demographics
NPI:1255473740
Name:SCOTT L HATZENBELER PC
Entity Type:Organization
Organization Name:SCOTT L HATZENBELER PC
Other - Org Name:ADVANCED CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:LEWIS
Authorized Official - Last Name:HATZENBELER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:480-632-0177
Mailing Address - Street 1:4365 E. PECOS RD.
Mailing Address - Street 2:SUITE 129
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85297
Mailing Address - Country:US
Mailing Address - Phone:480-632-0177
Mailing Address - Fax:480-632-5195
Practice Address - Street 1:4365 E. PECOS RD.
Practice Address - Street 2:SUITE 129
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85297
Practice Address - Country:US
Practice Address - Phone:480-632-0177
Practice Address - Fax:480-632-5195
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-13
Last Update Date:2008-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ7496111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty