Provider Demographics
NPI:1477922235
Name:HAYES FAMILY CHIROPRACTIC, PA
Entity Type:Organization
Organization Name:HAYES FAMILY CHIROPRACTIC, PA
Other - Org Name:CHIROPRACTIC CLINICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:DR
Authorized Official - First Name:DIANE
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHOEFFEL-HAYES
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:219-669-9110
Mailing Address - Street 1:1281 JASMINE LAKE DR
Mailing Address - Street 2:
Mailing Address - City:TARPON SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:34689-5265
Mailing Address - Country:US
Mailing Address - Phone:219-669-9110
Mailing Address - Fax:
Practice Address - Street 1:1281 JASMINE LAKE DR
Practice Address - Street 2:
Practice Address - City:TARPON SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:34689-5265
Practice Address - Country:US
Practice Address - Phone:219-669-9110
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-22
Last Update Date:2015-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH11529111N00000X
FLCH11530111N00000X
IN08002096A111N00000X
IN08002177A111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty