Healthcare Provider Details

I. General information

NPI: 1962446526
Provider Name (Legal Business Name): JARED L HALSEY D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: JARED L HALSEY D.C.

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. P.O. BOX 77
EDMORE MI
48829
US

V. Phone/Fax

Practice location:
  • Phone: 989-427-3457
  • Fax: 989-427-3487
Mailing address:
  • Phone: 989-427-3457
  • Fax: 989-427-3487

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberL766519
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: