Organization
JACKLITCH CHIROPRACTIC CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RANDAL JACKLITCH (OWNER)
(320) 243-7412
Entity
Organization
Contact information
Practice address
645 LAKE AVE S, PAYNESVILLE, MN 56362-1736
(320) 243-7412
Mailing address
645 LAKE AVE S, PAYNESVILLE, MN 56362-1736
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2434
MN
Other
Enumeration date
07/30/2007
Last updated
10/04/2007
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