Provider Demographics
NPI:1689914673
Name:HARTLAND FAMILY CHIROPRACTIC, LLC
Entity Type:Organization
Organization Name:HARTLAND FAMILY CHIROPRACTIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:HANS
Authorized Official - Middle Name:J
Authorized Official - Last Name:HALASKA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:262-367-7424
Mailing Address - Street 1:365 COTTONWOOD AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:HARTLAND
Mailing Address - State:WI
Mailing Address - Zip Code:53029-2048
Mailing Address - Country:US
Mailing Address - Phone:262-367-7424
Mailing Address - Fax:262-369-1068
Practice Address - Street 1:365 COTTONWOOD AVE
Practice Address - Street 2:SUITE A
Practice Address - City:HARTLAND
Practice Address - State:WI
Practice Address - Zip Code:53029-2048
Practice Address - Country:US
Practice Address - Phone:262-367-7424
Practice Address - Fax:262-369-1068
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-27
Last Update Date:2013-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4437-12111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty