Provider Demographics
NPI:1609817857
Name:HAGGARD, JOSEPH DARREL (DC)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:DARREL
Last Name:HAGGARD
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6701 W UNION HILLS DR
Mailing Address - Street 2:SUITE 2
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85308-8067
Mailing Address - Country:US
Mailing Address - Phone:602-843-6300
Mailing Address - Fax:602-843-3045
Practice Address - Street 1:6701 W UNION HILLS DR
Practice Address - Street 2:SUITE 2
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85308-8067
Practice Address - Country:US
Practice Address - Phone:602-843-6300
Practice Address - Fax:602-843-3045
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ7030111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor