Individual
KENNETH ROBERT HAYCOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
276 FEDERAL AVE NW, MASSILLON, OH 44647-5469
(330) 833-2085
(330) 833-2067
Mailing address
276 FEDERAL AVE NW, MASSILLON, OH 44647-5469
(330) 833-2085
(330) 833-2067
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
3515
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000491984
ANTHEM BC/BS
OH
05
—
2517100
—
OH
01
—
3515
OSCB
OH
01
—
7509586
AETNA
OH
01
—
Q044763
HOMETOWN
OH
Enumeration date
07/25/2006
Last updated
05/07/2009
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