Provider Demographics
NPI:1053869602
Name:HARTMAN, JUSTIN NOBLE (DC)
Entity type:Individual
Prefix:DR
First Name:JUSTIN
Middle Name:NOBLE
Last Name:HARTMAN
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 1:3951 BROWN TRL
Mailing Address - Street 2:
Mailing Address - City:COLLEYVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:76034-3959
Mailing Address - Country:US
Mailing Address - Phone:817-656-0046
Mailing Address - Fax:817-576-0037
Practice Address - Street 1:3951 BROWN TRL
Practice Address - Street 2:
Practice Address - City:COLLEYVILLE
Practice Address - State:TX
Practice Address - Zip Code:76034-3959
Practice Address - Country:US
Practice Address - Phone:817-656-0046
Practice Address - Fax:817-576-0037
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-12
Last Update Date:2016-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX13298111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor