Provider Demographics
NPI:1437744406
Name:AXBERG, HAILEY (DC)
Entity Type:Individual
Prefix:DR
First Name:HAILEY
Middle Name:
Last Name:AXBERG
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2165 9TH ST W UNIT 4
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA FALLS
Mailing Address - State:MT
Mailing Address - Zip Code:59912-4561
Mailing Address - Country:US
Mailing Address - Phone:406-219-8305
Mailing Address - Fax:
Practice Address - Street 1:2165 9TH ST W UNIT 4
Practice Address - Street 2:
Practice Address - City:COLUMBIA FALLS
Practice Address - State:MT
Practice Address - Zip Code:59912-4561
Practice Address - Country:US
Practice Address - Phone:406-219-8305
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-02
Last Update Date:2021-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTCHI-CHI-6737111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor