Provider Demographics
NPI:1811508369
Name:HAAK CHIROPRACTIC LLC
Entity type:Organization
Organization Name:HAAK CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:TAYLOR
Authorized Official - Middle Name:DENTON LEWIS
Authorized Official - Last Name:HAAK
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:913-638-0213
Mailing Address - Street 1:3807 FLORENTINE CIR
Mailing Address - Street 2:
Mailing Address - City:LONGMONT
Mailing Address - State:CO
Mailing Address - Zip Code:80503-6465
Mailing Address - Country:US
Mailing Address - Phone:913-638-0213
Mailing Address - Fax:
Practice Address - Street 1:6666 GUNPARK DR STE 100
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80301-3396
Practice Address - Country:US
Practice Address - Phone:913-638-0213
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-10
Last Update Date:2020-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty