Provider Demographics
NPI:1467817916
Name:HALSELL CHIROPRACTIC, LLC
Entity Type:Organization
Organization Name:HALSELL CHIROPRACTIC, LLC
Other - Org Name:ALIGN CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:HALSELL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:817-919-2171
Mailing Address - Street 1:319 NW RENFRO ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:BURLESON
Mailing Address - State:TX
Mailing Address - Zip Code:76028-3471
Mailing Address - Country:US
Mailing Address - Phone:817-919-2171
Mailing Address - Fax:
Practice Address - Street 1:319 NW RENFRO ST
Practice Address - Street 2:SUITE A
Practice Address - City:BURLESON
Practice Address - State:TX
Practice Address - Zip Code:76028-3471
Practice Address - Country:US
Practice Address - Phone:817-919-2171
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-29
Last Update Date:2016-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12899111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty