Individual
DR. JOHN DAVID HALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
616 N BEACON BLVD, GRAND HAVEN, MI 49417-1193
(616) 846-8788
Mailing address
13368 GREENBRIAR DR, GRAND HAVEN, MI 49417-9156
(616) 846-8882
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2301008495
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200504915380A
—
MI
01
—
2301008495
MICHIGAN STATE LICENSE
MI
05
—
4453210
—
MI
01
—
JH008495
BCBS PHYSICIAN NUMBER
MI
Enumeration date
04/19/2007
Last updated
07/09/2007
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