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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