Provider Demographics
NPI:1962446526
Name:HALSEY, JARED L (DC)
Entity Type:Individual
Prefix:DR
First Name:JARED
Middle Name:L
Last Name:HALSEY
Suffix:
Gender:M
Credentials:DC
Other - Prefix:DR
Other - First Name:JARED
Other - Middle Name:L
Other - Last Name:HALSEY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC
Mailing Address - Street 1:503 E. MAIN ST.
Mailing Address - Street 2:P.O. BOX 77
Mailing Address - City:EDMORE
Mailing Address - State:MI
Mailing Address - Zip Code:48829
Mailing Address - Country:US
Mailing Address - Phone:989-427-3457
Mailing Address - Fax:989-427-3487
Practice Address - Street 1:503 E. MAIN ST.
Practice Address - Street 2:
Practice Address - City:EDMORE
Practice Address - State:MI
Practice Address - Zip Code:48829
Practice Address - Country:US
Practice Address - Phone:989-427-3457
Practice Address - Fax:989-427-3487
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-15
Last Update Date:2007-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIL766519111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIL766519OtherCHIROPRACTOR LICENSE