Provider Demographics
NPI:1679740690
Name:HAWLEY, ANDREW JAMES (DC)
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:JAMES
Last Name:HAWLEY
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 1:405 GROW AVE
Mailing Address - Street 2:
Mailing Address - City:MONTROSE
Mailing Address - State:PA
Mailing Address - Zip Code:18801-1105
Mailing Address - Country:US
Mailing Address - Phone:860-384-0267
Mailing Address - Fax:
Practice Address - Street 1:405 GROW AVE
Practice Address - Street 2:
Practice Address - City:MONTROSE
Practice Address - State:PA
Practice Address - Zip Code:18801-1105
Practice Address - Country:US
Practice Address - Phone:860-384-0267
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-08
Last Update Date:2020-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC010864111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor