MEDICARE: 100 CHIRO HALL PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor

General Provider Information

NPI Number	:	1215524392
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	100 CHIRO HALL PLLC

Provider Business Mailing Address
First Line	:	1451 N 200 E
Second Line	:
City	:	LOGAN
State	:	UT
Zip	:	84341-7570
Country	:	US
Telephone Number	:	435-799-3105
Fax Number	:	435-535-3473

Provider Business Practice Location Address
First Line	:	682 S MAIN ST STE 150
Second Line	:
City	:	LOGAN
State	:	UT
Zip	:	84321-6567
Country	:	US
Telephone Number	:	404-578-5818
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. JARED VERNON HALL
Credential	:	DC
Telephone Number	:	404-578-5818

Provider Enumeration Date	:	12/23/2020
Last Update Date	:	03/25/2026

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Directions to “100 CHIRO HALL PLLC ” Practice Location

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