Provider Demographics
NPI:1730503285
Name:HAZLETT, STEPHEN ROBERT (DC)
Entity type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:ROBERT
Last Name:HAZLETT
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1361 FRUITVILLE PIKE
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17601-4001
Mailing Address - Country:US
Mailing Address - Phone:717-299-9600
Mailing Address - Fax:717-299-4146
Practice Address - Street 1:1361 FRUITVILLE PIKE
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17601-4001
Practice Address - Country:US
Practice Address - Phone:717-299-9600
Practice Address - Fax:717-299-4146
Is Sole Proprietor?:No
Enumeration Date:2014-02-04
Last Update Date:2014-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC010800111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor