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General NPI Number Information
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NPI Number | 1326292921
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Entity Type | Organization
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Legal Business Name | HALL FAMILY CHIROPRACTIC, PC
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Dates
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Enumeration Date | 11/10/2008
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Last Update Date | 10/23/2012
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Provider Practice Location Address
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Address Line | 317 SOUTH BEACON BLVD.
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City | GRAND HAVEN
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State | MI
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Zip | 49417-1948
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Country | US
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Telephone | 616-846-8788
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Fax | 616-846-8796
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Provider Business Mailing Address
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Address Line | 317 SOUTH BEACON BLVD.
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City | GRAND HAVEN
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State | MI
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Zip | 49417-1948
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Country | US
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Telephone | 616-846-8788
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Fax | 616-846-8796
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | STACY LYNN HALL
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Credential | DC
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Telephone | 616-846-8788
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 2301008495
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License Number State | MI
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