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General NPI Number Information
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NPI Number | 1194778662
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Entity Type | Organization
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Legal Business Name | HALBERG CHIROPRACTIC CLINIC, PLLC
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Dates
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Enumeration Date | 05/18/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 430 E LAURIDSEN BLVD SUITE 113
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City | PORT ANGELES
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State | WA
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Zip | 98362-7978
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Country | US
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Telephone | 360-457-7576
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Fax | 360-452-8079
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Provider Business Mailing Address
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Address Line | 430 E LAURIDSEN BLVD SUITE 113
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City | PORT ANGELES
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State | WA
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Zip | 98362-7978
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Country | US
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Telephone | 360-457-7576
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Fax | 360-452-8079
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Authorized Official
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Title or Position | MEMBER
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Name | DR. JAMES GUSTAF HALBERG
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Credential | D.C.
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Telephone | 360-457-7576
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | CH00034213
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License Number State | WA
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