Provider Demographics
NPI:1629566328
Name:CHANCE, HAYDEN C (DC)
Entity Type:Individual
Prefix:
First Name:HAYDEN
Middle Name:C
Last Name:CHANCE
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 1:1240 NW 11TH AVE STE A
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32601-3097
Mailing Address - Country:US
Mailing Address - Phone:352-375-6972
Mailing Address - Fax:352-377-6945
Practice Address - Street 1:1240 NW 11TH AVE STE A
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32601-3097
Practice Address - Country:US
Practice Address - Phone:352-375-6972
Practice Address - Fax:352-377-6945
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-27
Last Update Date:2018-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH12466111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor