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General NPI Number Information
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NPI Number | 1811226095
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Entity Type | Organization
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Legal Business Name | HALLACKER CHIROPRACTIC CENTER LLC
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Dates
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Enumeration Date | 12/16/2009
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Last Update Date | 12/16/2009
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Provider Practice Location Address
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Address Line | 2764 RTE 23
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City | STOCKHOLM
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State | NJ
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Zip | 07460-1326
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Country | US
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Telephone | 973-697-2800
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Fax | 973-697-7606
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Provider Business Mailing Address
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Address Line | 2764 RTE 23 PO BOX 636
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City | STOCKHOLM
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State | NJ
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Zip | 07460-1326
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Country | US
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Telephone | 973-697-2800
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Fax | 973-697-7606
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Authorized Official
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Title or Position | OWNER
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Name | DR. MICHAEL L. HALLACKER
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Credential | D.C.
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Telephone | 973-697-2800
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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 | MC00438
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License Number State | NJ
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