Individual
DR. JEREMIAH LUKE BURSCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
12 2ND AVE S, SAUK RAPIDS, MN 56379-1408
(320) 257-6008
(320) 257-6009
Mailing address
12 2ND AVE S, SAUK RAPIDS, MN 56379-1408
(320) 257-6008
(320) 257-6009
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
4107
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
235764000
—
MN
01
—
618536
CHIROCARE PROVIDER NUMBER
MN
01
—
831S1BU
BCBS PROVIDER NUMBER
MN
01
—
P00119927
RAILROAD MEDICARE PROVIDE
MN
Enumeration date
12/06/2006
Last updated
12/30/2013
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