Provider Demographics
NPI:1962286328
Name:HACKENBURG, LYNDSIE JOAN KAREN (DC)
Entity type:Individual
Prefix:DR
First Name:LYNDSIE
Middle Name:JOAN KAREN
Last Name:HACKENBURG
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 1:5021 W ST JOE HWY STE 1
Mailing Address - Street 2:
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48917-4027
Mailing Address - Country:US
Mailing Address - Phone:517-394-3353
Mailing Address - Fax:517-394-2723
Practice Address - Street 1:5021 W ST JOE HWY STE 1
Practice Address - Street 2:
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48917-4027
Practice Address - Country:US
Practice Address - Phone:517-394-3353
Practice Address - Fax:517-394-2723
Is Sole Proprietor?:No
Enumeration Date:2023-08-24
Last Update Date:2023-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301401451111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor