Provider Demographics
NPI:1609916097
Name:JDH CHIROPRACTIC INC
Entity Type:Organization
Organization Name:JDH CHIROPRACTIC INC
Other - Org Name:HAGGARD CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:DARREL
Authorized Official - Last Name:HAGGARD
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:602-843-6300
Mailing Address - Street 1:18205 N 51ST AVE
Mailing Address - Street 2:SUITE 147
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85308-1490
Mailing Address - Country:US
Mailing Address - Phone:602-843-6300
Mailing Address - Fax:602-997-7797
Practice Address - Street 1:18205 N 51ST AVE
Practice Address - Street 2:SUITE 147
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85308-1490
Practice Address - Country:US
Practice Address - Phone:602-843-6300
Practice Address - Fax:602-997-7797
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-07
Last Update Date:2009-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ7030111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty