Provider Demographics
NPI:1770259608
Name:100 CHIRO HAYNES PLLC
Entity Type:Organization
Organization Name:100 CHIRO HAYNES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINIC DIRECTOR/ OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NORQUITTA
Authorized Official - Middle Name:Y
Authorized Official - Last Name:HAYNES
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:347-930-2085
Mailing Address - Street 1:4710 PRESTON RD STE 308
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034-8547
Mailing Address - Country:US
Mailing Address - Phone:347-930-2085
Mailing Address - Fax:
Practice Address - Street 1:4710 PRESTON RD STE 308
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034-8547
Practice Address - Country:US
Practice Address - Phone:347-930-2085
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-19
Last Update Date:2021-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty