# ACTIVE FAMILY CHIROPRACTIC, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1417311531
- **Authorized official:** DR. BARRY DANIEL HAZEN D.C. (SOLE MEMBER/OWNER)
- **Authorized official phone:** (717) 947-7283

## Contact information

- **Practice address:** 4 MYLIN AVE, WILLOW STREET, PA 17584-9305
- **Practice address phone:** (717) 947-7283
- **Practice address fax:** (717) 947-7284
- **Mailing address:** 4 MYLIN AVE, WILLOW STREET, PA 17584-9305
- **Mailing address phone:** (717) 947-7283
- **Mailing address fax:** (717) 947-7284

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | DC010513 | PA | Yes |

## Other

- **Enumeration date:** 04/06/2016
- **Last updated:** 04/06/2016