Provider Demographics
NPI:1730641002
Name:HAWKINS HEALTH CENTER OF ODON LLC
Entity Type:Organization
Organization Name:HAWKINS HEALTH CENTER OF ODON LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LESLIE
Authorized Official - Middle Name:BROOKE
Authorized Official - Last Name:HAWKINS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:812-295-3346
Mailing Address - Street 1:1 LOOGOOTEE PLZ
Mailing Address - Street 2:
Mailing Address - City:LOOGOOTEE
Mailing Address - State:IN
Mailing Address - Zip Code:47553-5757
Mailing Address - Country:US
Mailing Address - Phone:812-295-3346
Mailing Address - Fax:812-295-4489
Practice Address - Street 1:102 S SPRING ST
Practice Address - Street 2:
Practice Address - City:ODON
Practice Address - State:IN
Practice Address - Zip Code:47562-1314
Practice Address - Country:US
Practice Address - Phone:812-636-8101
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-04
Last Update Date:2019-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty