Provider Demographics
NPI:1255092730
Name:FINE, HALEY MARIE
Entity type:Individual
Prefix:DR
First Name:HALEY
Middle Name:MARIE
Last Name:FINE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4211 COMMONS DR W UNIT 1312
Mailing Address - Street 2:
Mailing Address - City:DESTIN
Mailing Address - State:FL
Mailing Address - Zip Code:32541-8622
Mailing Address - Country:US
Mailing Address - Phone:217-801-8175
Mailing Address - Fax:
Practice Address - Street 1:4014 COMMONS DR W STE 114
Practice Address - Street 2:
Practice Address - City:DESTIN
Practice Address - State:FL
Practice Address - Zip Code:32541-8425
Practice Address - Country:US
Practice Address - Phone:850-654-8770
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-06
Last Update Date:2022-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH13858111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor