Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NX0800X | Chiropractor Orthopedic Specialist | 4451 | CO |
NPI | 1609908458 |
---|---|
Provider Name | Dr. Eric A Haynie |
First Address | Aspen, CO 81612-1029 |
Second Address | Aspen, CO 81611-1981 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/03/2007 |
Last Update Date | 08/07/2007 |