Provider Demographics
NPI:1154305282
Name:HALLE, DARON GUY (DC)
Entity Type:Individual
Prefix:DR
First Name:DARON
Middle Name:GUY
Last Name:HALLE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8877 W UNION HILLS DR
Mailing Address - Street 2:#300
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85382-3008
Mailing Address - Country:US
Mailing Address - Phone:623-583-8190
Mailing Address - Fax:623-583-8788
Practice Address - Street 1:8877 W UNION HILLS DR
Practice Address - Street 2:#300
Practice Address - City:PEORIA
Practice Address - State:AZ
Practice Address - Zip Code:85382-3008
Practice Address - Country:US
Practice Address - Phone:623-583-8190
Practice Address - Fax:623-583-8788
Is Sole Proprietor?:No
Enumeration Date:2005-12-01
Last Update Date:2012-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ8002111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ81366Medicare ID - Type Unspecified
AZV00079Medicare UPIN