Provider Demographics
NPI:1376560011
Name:FINKLE, HARLEY (DC)
Entity Type:Individual
Prefix:DR
First Name:HARLEY
Middle Name:
Last Name:FINKLE
Suffix:
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 3358
Mailing Address - Street 2:
Mailing Address - City:LAKE HAVASU CITY
Mailing Address - State:AZ
Mailing Address - Zip Code:86405-3358
Mailing Address - Country:US
Mailing Address - Phone:928-680-1123
Mailing Address - Fax:928-680-3203
Practice Address - Street 1:1674 MCCULLOCH BLVD N
Practice Address - Street 2:
Practice Address - City:LAKE HAVASU CITY
Practice Address - State:AZ
Practice Address - Zip Code:86403-0962
Practice Address - Country:US
Practice Address - Phone:928-680-1123
Practice Address - Fax:928-680-3203
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-17
Last Update Date:2016-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC15200111N00000X
NVB01311111N00000X
CADC 15200111NI0013X
AZ5295111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NI0013XChiropractic ProvidersChiropractorIndependent Medical Examiner
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC0152000Medicare UPIN