Provider Demographics
NPI:1528327921
Name:LANCE HATCH
Entity type:Organization
Organization Name:LANCE HATCH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTIC PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:LANCE
Authorized Official - Middle Name:R
Authorized Official - Last Name:HATCH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:314-306-8086
Mailing Address - Street 1:1575 KISKER RD
Mailing Address - Street 2:
Mailing Address - City:SAINT CHARLES
Mailing Address - State:MO
Mailing Address - Zip Code:63304-0608
Mailing Address - Country:US
Mailing Address - Phone:636-922-4140
Mailing Address - Fax:636-922-4113
Practice Address - Street 1:1575 KISKER RD
Practice Address - Street 2:
Practice Address - City:SAINT CHARLES
Practice Address - State:MO
Practice Address - Zip Code:63304-0608
Practice Address - Country:US
Practice Address - Phone:636-922-4140
Practice Address - Fax:636-922-4113
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-07
Last Update Date:2017-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2011022443261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center