Organization
HAYCOCK CHIROPRACTIC PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JASON DALE HAYCOCK DC (PRESIDENT)
(208) 855-2688
Entity
Organization
Contact information
Practice address
1773 S MILLENIUM WAY, MARIDIAN, ID 83642-1511
(208) 855-2688
(208) 855-2689
Mailing address
1773 S MILLENIUM WAY, MARIDIAN, ID 83642-1511
(208) 855-2688
(208) 855-2689
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
—
Other
Enumeration date
11/27/2006
Last updated
08/22/2020
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