Provider Demographics
NPI:1689644916
Name:HAALA-HELGET, JILL (DC)
Entity Type:Individual
Prefix:
First Name:JILL
Middle Name:
Last Name:HAALA-HELGET
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:512 2ND STREET
Mailing Address - Street 2:PO BOX 103
Mailing Address - City:MORGAN
Mailing Address - State:MN
Mailing Address - Zip Code:56266-0103
Mailing Address - Country:US
Mailing Address - Phone:507-249-4900
Mailing Address - Fax:507-249-4901
Practice Address - Street 1:512 2ND STREET
Practice Address - Street 2:
Practice Address - City:MORGAN
Practice Address - State:MN
Practice Address - Zip Code:56266-0103
Practice Address - Country:US
Practice Address - Phone:507-249-4900
Practice Address - Fax:507-249-4901
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-26
Last Update Date:2017-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN4491111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN663931OtherCHIROCARE PROVIDER ID
MN637653300OtherMEDICAL ASSISTANCE ID
MN264K3BOOtherBCBS PROVIDER ID
MN350003129Medicare ID - Type UnspecifiedMEDICARE PROVIDER ID