Provider Demographics
NPI:1093800674
Name:HALEY, LINDA ROSE (DC)
Entity type:Individual
Prefix:DR
First Name:LINDA
Middle Name:ROSE
Last Name:HALEY
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 1:5 ARCHELAUS PLACE
Mailing Address - Street 2:
Mailing Address - City:WEST NEWBURY
Mailing Address - State:MA
Mailing Address - Zip Code:01985
Mailing Address - Country:US
Mailing Address - Phone:978-521-9501
Mailing Address - Fax:
Practice Address - Street 1:350 MAIN ST STE 6
Practice Address - Street 2:
Practice Address - City:HAVERHILL
Practice Address - State:MA
Practice Address - Zip Code:01830-4036
Practice Address - Country:US
Practice Address - Phone:978-521-9501
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2010-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2147111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAHAY45177Medicare ID - Type Unspecified