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General NPI Number Information
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NPI Number | 1023222478
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Entity Type | Organization
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Legal Business Name | VADNAIS HEIGHTS FAMILY CHIROPRACTIC, INC.
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Dates
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Enumeration Date | 05/09/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1038 CENTERVILLE CIR
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City | VADNAIS HEIGHTS
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State | MN
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Zip | 55127-6344
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Country | US
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Telephone | 651-762-7475
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Fax | 651-762-7544
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Provider Business Mailing Address
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Address Line | 1038 CENTERVILLE CIR
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City | VADNAIS HEIGHTS
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State | MN
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Zip | 55127-6344
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Country | US
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Telephone | 651-762-7475
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Fax | 651-762-7544
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MICHAEL JON HALLINGSTAD
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Credential | D.C.
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Telephone | 651-762-7475
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NR0400X
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Taxonomy Name | Rehabilitation Chiropractor
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License Number | 4396
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License Number State | MN
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