Provider Demographics
NPI:1518252758
Name:ELIZABETH HACKLEMAN D C INC
Entity Type:Organization
Organization Name:ELIZABETH HACKLEMAN D C INC
Other - Org Name:ROCKPORT CHIROPRACTIC & ACCUPUNCTURE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:D.C./OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:V
Authorized Official - Last Name:HACKLEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:816-716-7144
Mailing Address - Street 1:2867 HIGHWAY 35 NORTH
Mailing Address - Street 2:
Mailing Address - City:ROCKPORT
Mailing Address - State:TX
Mailing Address - Zip Code:78382
Mailing Address - Country:US
Mailing Address - Phone:816-716-7144
Mailing Address - Fax:
Practice Address - Street 1:2867 HIGHWAY 35 NORTH
Practice Address - Street 2:
Practice Address - City:ROCKPORT
Practice Address - State:TX
Practice Address - Zip Code:78382
Practice Address - Country:US
Practice Address - Phone:816-716-7144
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-16
Last Update Date:2012-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX7944111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty