Individual
MR. MIKE JON HALLINGSTAD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
1038 CENTERVILLE CIR, VADNAIS HEIGHTS, MN 55127-6344
(651) 762-7475
(651) 762-7544
Mailing address
1038 CENTERVILLE CIR, VADNAIS HEIGHTS, MN 55127-6344
(651) 762-7475
(651) 762-7544
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
4396
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
059K3VA
BLUE CROSS BLUE SHEILD
MN
Enumeration date
01/30/2007
Last updated
07/08/2007
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