Organization
HAZUKA SPINAL CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARTIN LEE HAZUKA DACBSP (CHIROPRACTOR)
(920) 468-4755
Entity
Organization
Contact information
Practice address
1742 E MASON ST, GREEN BAY, WI 54302-3259
(920) 468-4755
(920) 468-4044
Mailing address
1742 E MASON ST, GREEN BAY, WI 54302-3259
(920) 468-4755
(920) 468-4044
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1340-12
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000075467
PTAN
WI
Enumeration date
02/08/2010
Last updated
02/08/2010
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