Individual
ELIZABETH VICTORIA HACKLEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.C.
Contact information
Practice address
2867 HIGHWAY 35 NORTH, ROCKPORT, TX 78382
(816) 716-7144
Mailing address
2867 HIGHWAY 35 NORTH, ROCKPORT, TX 78382
(816) 716-7144
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
006634
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10851251
CAQH CREDENTIALING
MO
01
—
24778022
BCBS KC
MO
01
—
350054223
RRMM
MO
01
—
4401089
UHC
MO
01
—
5464712
AETNA
MO
Enumeration date
08/11/2005
Last updated
06/02/2011
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