Provider Demographics
NPI:1932304722
Name:HALPIN FAMILY CHIROPRACTIC AND REHAB CENTER S.C.
Entity Type:Organization
Organization Name:HALPIN FAMILY CHIROPRACTIC AND REHAB CENTER S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:SEAN
Authorized Official - Middle Name:CEDRIC
Authorized Official - Last Name:HALPIN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:262-662-9820
Mailing Address - Street 1:W236 S7050 HWY 164 STE. 4
Mailing Address - Street 2:
Mailing Address - City:BIG BEND
Mailing Address - State:WI
Mailing Address - Zip Code:53103
Mailing Address - Country:US
Mailing Address - Phone:262-662-9820
Mailing Address - Fax:262-662-9821
Practice Address - Street 1:W236 S7050 HWY 164 STE. 4
Practice Address - Street 2:
Practice Address - City:BIG BEND
Practice Address - State:WI
Practice Address - Zip Code:53103
Practice Address - Country:US
Practice Address - Phone:262-662-9820
Practice Address - Fax:262-662-9821
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-20
Last Update Date:2008-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3674-012111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI38928600Medicaid
WI38928600Medicaid
WI000035628Medicare ID - Type Unspecified