Provider Demographics
NPI:1588708697
Name:HAUGER CHIROPRACTIC LIFE CENTER, P.C
Entity type:Organization
Organization Name:HAUGER CHIROPRACTIC LIFE CENTER, P.C
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:G
Authorized Official - Last Name:HAUGER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:770-452-0022
Mailing Address - Street 1:1745 OLD SPRING HOUSE LN
Mailing Address - Street 2:SUITE 418
Mailing Address - City:DUNWOODY
Mailing Address - State:GA
Mailing Address - Zip Code:30338-6216
Mailing Address - Country:US
Mailing Address - Phone:770-452-0022
Mailing Address - Fax:770-452-7266
Practice Address - Street 1:1745 OLD SPRING HOUSE LN
Practice Address - Street 2:SUITE 418
Practice Address - City:DUNWOODY
Practice Address - State:GA
Practice Address - Zip Code:30338-6216
Practice Address - Country:US
Practice Address - Phone:770-452-0022
Practice Address - Fax:770-452-7266
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0001143111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty