Active Life Chiropractic and Sport LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

4735 Issued in MN

Legal business name

ACTIVE LIFE CHIROPRACTIC AND SPORT LLC

Practice address

600 Union St S
Mora, MN 55051-1870

Phone

(320) 225-1017

NPI assigned

Nov 29, 2007

Last updated

Nov 29, 2007By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Casey James Hallin, D.C.

Title

C.E.O.

Phone

(320) 225-1017

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1196294400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196294400000",
    "number": "1558543751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 UNION ST S",
            "city": "MORA",
            "state": "MN",
            "postal_code": "550511870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 UNION ST S",
            "city": "MORA",
            "state": "MN",
            "postal_code": "550511870",
            "telephone_number": "320-225-1017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACTIVE LIFE CHIROPRACTIC AND SPORT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-29",
        "last_updated": "2007-11-29",
        "status": "A",
        "authorized_official_last_name": "HALLIN",
        "authorized_official_first_name": "CASEY",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "C.E.O.",
        "authorized_official_telephone_number": "320-225-1017",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "4735",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• 127 Ministries PSC (127 Ministries)
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• Heather Alexander, MA OTR/L
• Matthew Gordon Allen, M.D.
• Abagail LM Anderson, LADC
• Ibkhan Ansine, MD

• Chiropractor in Mora, MN
• Providers in Mora, MN by specialty
• Chiropractor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.