Provider Demographics
NPI:1831619576
Name:PETERSON, HAHJA LYNNE (DC)
Entity type:Individual
Prefix:
First Name:HAHJA
Middle Name:LYNNE
Last Name:PETERSON
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3933 SPICEWOOD SPRINGS RD STE E400
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78759-8756
Mailing Address - Country:US
Mailing Address - Phone:512-338-8812
Mailing Address - Fax:512-338-8815
Practice Address - Street 1:3933 SPICEWOOD SPRINGS RD STE E400
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78759-8756
Practice Address - Country:US
Practice Address - Phone:512-338-8812
Practice Address - Fax:512-338-8815
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-23
Last Update Date:2017-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12903111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor