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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