MEDICARE: DR. JARED L HALSEY D.C.

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	L766519	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	L766519	OTHER	MI	CHIROPRACTOR LICENSE

General Provider Information

NPI Number	:	1962446526
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JARED L HALSEY D.C.

Provider Business Mailing Address
First Line	:	503 E. MAIN ST.
Second Line	:	P.O. BOX 77
City	:	EDMORE
State	:	MI
Zip	:	48829
Country	:	US
Telephone Number	:	989-427-3457
Fax Number	:	989-427-3487

Provider Business Practice Location Address
First Line	:	503 E. MAIN ST.
Second Line	:
City	:	EDMORE
State	:	MI
Zip	:	48829
Country	:	US
Telephone Number	:	989-427-3457
Fax Number	:	989-427-3487

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/15/2006
Last Update Date	:	11/27/2007

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