Haycock Chiropractic PC

NPI #1073689618 in Maridian, Idaho

Provider Information

NPI Number: 1073689618
Entity Type: Organization
Organization Name: Haycock Chiropractic PC
Primary Specialty: Chiropractor
Enumeration Date: Nov 27, 2006
Last Updated: Aug 22, 2020

Practice Location

Address: 1773 S MILLENIUM WAY
City: Maridian
State: Idaho
ZIP Code: 83642-1511
Phone: (208) 855-2688

Authorized Official

Name: JASON DALE HAYCOCK, DC
Title: PRESIDENT
Phone: (208) 855-2688

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Chiropractor	111N00000X	Primary

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