Provider Demographics
NPI:1013112267
Name:HAAN FAMILY CHIROPRACTIC
Entity Type:Organization
Organization Name:HAAN FAMILY CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BLAKE
Authorized Official - Middle Name:LOWELL
Authorized Official - Last Name:HAAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:515-597-4600
Mailing Address - Street 1:108 N US HIGHWAY 69
Mailing Address - Street 2:PO BOX 262
Mailing Address - City:HUXLEY
Mailing Address - State:IA
Mailing Address - Zip Code:50124-9334
Mailing Address - Country:US
Mailing Address - Phone:515-597-4600
Mailing Address - Fax:
Practice Address - Street 1:108 N US HIGHWAY 69
Practice Address - Street 2:
Practice Address - City:HUXLEY
Practice Address - State:IA
Practice Address - Zip Code:50124-0262
Practice Address - Country:US
Practice Address - Phone:515-597-4600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-18
Last Update Date:2016-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAAO5865111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA350051453OtherRAILROAD RETIREMENT
IAI15241Medicare PIN