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Individual
BRIAN G HACKLEMAN
Active
Individual
BRIAN G HACKLEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
006529
MO
171100000X
Acupuncturist
006529
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000025678
MEDICARE PTAN
MO
01
—
188731
BCBS OF MO
MO
05
—
230073733
—
MO
Enumeration date
05/31/2006
Last updated
12/15/2023
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