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Organization
ACTIVE LIFE CHIROPRACTIC AND SPORT LLC
Active
Organization
ACTIVE LIFE CHIROPRACTIC AND SPORT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CASEY JAMES HALLIN D.C. (C.E.O.)
(320) 225-1017
Entity
Organization
Contact information
Practice address
600 UNION ST S, MORA, MN 55051-1870
(320) 225-1017
Mailing address
600 UNION ST S, MORA, MN 55051-1870
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
4735
MN
Other
Enumeration date
11/29/2007
Last updated
11/29/2007
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