Provider Demographics
NPI:1750538708
Name:HARDIN CHIROPRACTIC AZZ INC PC
Entity type:Organization
Organization Name:HARDIN CHIROPRACTIC AZZ INC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BILL
Authorized Official - Middle Name:W
Authorized Official - Last Name:HARDIN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:734-283-2180
Mailing Address - Street 1:20720 EUREKA RD
Mailing Address - Street 2:
Mailing Address - City:TAYLOR
Mailing Address - State:MI
Mailing Address - Zip Code:48180-5313
Mailing Address - Country:US
Mailing Address - Phone:734-283-2180
Mailing Address - Fax:
Practice Address - Street 1:20720 EUREKA RD
Practice Address - Street 2:
Practice Address - City:TAYLOR
Practice Address - State:MI
Practice Address - Zip Code:48180-5313
Practice Address - Country:US
Practice Address - Phone:734-283-2180
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-21
Last Update Date:2008-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIBH004630111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
T33834OtherHAP
MI1104896109OtherINDIVIDUAL NPI
MI350022634OtherRAILROAD MEDICARE
MI950H228260OtherBCBS
MI1407035Medicaid
MI1407035Medicaid