Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | CH8800 | FL |
NPI | 1003027590 |
---|---|
Provider Name | Frederick D Haines |
First Address | Gainesville, FL 32609-2994 |
Second Address | Gainesville, FL 32609-2994 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/05/2007 |
Last Update Date | 03/11/2008 |