Organization
RENFRED R. HALVERSON DC., P.C.
Active
Other names
Advanced Chiropractic Center
Organization subpart
No
Provider details
NPI number
Authorized official
REN R HALVERSON DC (OWNER/ADMINISTRATOR)
(912) 262-9735
Entity
Organization
Contact information
Practice address
1510 NEWCASTLE ST STE 200, BRUNSWICK, GA 31520-6825
(912) 262-9735
(912) 262-9634
Mailing address
1510 NEWCASTLE ST STE 200, BRUNSWICK, GA 31520-6825
(912) 262-9735
(912) 262-9634
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
CHIRO01742
GA
111N00000X
Chiropractor
Primary
GA1742
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1043324296
GROUP NPI NUMBER
GA
01
—
GRP7792
PTAN #
GA
Enumeration date
08/17/2006
Last updated
05/05/2023
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