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Organization
CROW RIVER ENTERPRISES
Active
Organization
CROW RIVER ENTERPRISES
Active
Other names
DBA CROW RIVER CHIROPRACTIC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RANDY JOHAN JURGENSON DC (OWNER/CHIROPRACTOR)
(320) 587-2215
Entity
Organization
Contact information
Practice address
1507 JEFFERSON ST SE, SUITE 1, HUTCHINSON, MN 55350
(320) 587-2215
Mailing address
1507 JEFFERSON ST SE, SUITE 1, HUTCHINSON, MN 55350
(320) 587-2215
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
3383
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0303
PREFERRED ONE
MN
05
—
344727800
—
MN
01
—
54F01CR
BLUE CROSS BLUE SHIELD
MN
01
—
603860
ACN CHIROCARE
MN
Enumeration date
08/13/2007
Last updated
01/06/2011
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