Provider Demographics
NPI:1447386677
Name:HAVRO INC
Entity Type:Organization
Organization Name:HAVRO INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRES
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:D
Authorized Official - Last Name:ROGAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:330-717-6339
Mailing Address - Street 1:3126 53RD AVE. E. SR70
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34203-4311
Mailing Address - Country:US
Mailing Address - Phone:941-752-3352
Mailing Address - Fax:
Practice Address - Street 1:3126 53RD AVE. E. SR70
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34203-4311
Practice Address - Country:US
Practice Address - Phone:941-752-3352
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-23
Last Update Date:2007-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2664111N00000X
FLCH 9114111N00000X
OH2571111N00000X
FLCH 9178111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty