Healthcare Provider Details
I. General information
NPI: 1346284775
Provider Name (Legal Business Name): HALSEY FAMILY CHIROPRACTIC, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/15/2006
Last Update Date: 11/27/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
503 E MAIN ST
EDMORE MI
48829
US
IV. Provider business mailing address
503 E. MAIN ST PO BOX 77
EDMORE MI
48829
US
V. Phone/Fax
- Phone: 989-427-3457
- Fax: 989-427-3487
- Phone: 989-427-3457
- Fax: 989-427-3487
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 111N00000X |
| Taxonomy | Chiropractor |
| License Number | 2301009108 |
| License Number State | MI |
VIII. Authorized Official
Name: DR.
JARED
L
HALSEY
Title or Position: DOCTOR OF CHIROPRACTIC
Credential: D.C.
Phone: 989-427-3457