Provider Demographics
NPI:1295062073
Name:HAUGEN, CHANCE
Entity type:Individual
Prefix:
First Name:CHANCE
Middle Name:
Last Name:HAUGEN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 2ND ST NW
Mailing Address - Street 2:
Mailing Address - City:ORTONVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:56278-1407
Mailing Address - Country:US
Mailing Address - Phone:320-808-0452
Mailing Address - Fax:
Practice Address - Street 1:16 2ND ST NW
Practice Address - Street 2:
Practice Address - City:ORTONVILLE
Practice Address - State:MN
Practice Address - Zip Code:56278-1407
Practice Address - Country:US
Practice Address - Phone:320-808-0452
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-11-16
Last Update Date:2023-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN5291111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor