Provider Demographics
NPI:1477649739
Name:HAKE, WILLIAM THOMAS (DC)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:THOMAS
Last Name:HAKE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:WILLIAM
Other - Middle Name:
Other - Last Name:HAKE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:6550 YORK AVE S
Mailing Address - Street 2:STE 216
Mailing Address - City:EDINA
Mailing Address - State:MN
Mailing Address - Zip Code:55435-2347
Mailing Address - Country:US
Mailing Address - Phone:952-746-7533
Mailing Address - Fax:
Practice Address - Street 1:6550 YORK AVE S
Practice Address - Street 2:STE 216
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55435-2347
Practice Address - Country:US
Practice Address - Phone:952-746-7533
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN4583111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor