Provider Demographics
NPI:1497242192
Name:BRIAN G. HACKLEMAN, D.C., L.L.C.
Entity Type:Organization
Organization Name:BRIAN G. HACKLEMAN, D.C., L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:GEORGE
Authorized Official - Last Name:HACKLEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DOCTOR OF CHIROPRACT
Authorized Official - Phone:417-326-3527
Mailing Address - Street 1:341 S SPRINGFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:BOLIVAR
Mailing Address - State:MO
Mailing Address - Zip Code:65613-2040
Mailing Address - Country:US
Mailing Address - Phone:417-326-3527
Mailing Address - Fax:417-326-3529
Practice Address - Street 1:341 S SPRINGFIELD AVE
Practice Address - Street 2:
Practice Address - City:BOLIVAR
Practice Address - State:MO
Practice Address - Zip Code:65613-2040
Practice Address - Country:US
Practice Address - Phone:417-326-3527
Practice Address - Fax:417-326-3529
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-18
Last Update Date:2023-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty