Provider Demographics
NPI:1548389679
Name:HAAK CHIROPRACTIC, INC.
Entity Type:Organization
Organization Name:HAAK CHIROPRACTIC, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:HAAK
Authorized Official - Suffix:
Authorized Official - Credentials:DC, BS
Authorized Official - Phone:920-269-7705
Mailing Address - Street 1:677 S. WATER ST.
Mailing Address - Street 2:P.O. BOX 142
Mailing Address - City:LOMIRA
Mailing Address - State:WI
Mailing Address - Zip Code:53048
Mailing Address - Country:US
Mailing Address - Phone:920-269-7705
Mailing Address - Fax:
Practice Address - Street 1:677 S. WATER ST.
Practice Address - Street 2:
Practice Address - City:LOMIRA
Practice Address - State:WI
Practice Address - Zip Code:53048
Practice Address - Country:US
Practice Address - Phone:920-269-7705
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-28
Last Update Date:2012-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3410-012111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty