Individual
BRIAN G HACKLEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
341 S SPRINGFIELD AVE, BOLIVAR, MO 65613-2040
(417) 326-3527
(417) 326-3529
Mailing address
341 S SPRINGFIELD AVE, BOLIVAR, MO 65613-2040
(417) 326-3527
(417) 326-3529
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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