Provider Demographics
NPI:1023175734
Name:HAUG, JAMES M (DC)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:M
Last Name:HAUG
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:113 S A ST
Mailing Address - Street 2:PO BOX 8
Mailing Address - City:GRANGEVILLE
Mailing Address - State:ID
Mailing Address - Zip Code:83530-1428
Mailing Address - Country:US
Mailing Address - Phone:208-983-2458
Mailing Address - Fax:208-983-1554
Practice Address - Street 1:113 S A ST
Practice Address - Street 2:
Practice Address - City:GRANGEVILLE
Practice Address - State:ID
Practice Address - Zip Code:83530-1428
Practice Address - Country:US
Practice Address - Phone:208-983-2458
Practice Address - Fax:208-983-1554
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDC552111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor