Individual
DR. MICHAEL GORDON JORGENSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
1110 BUCKEYE AVENUE, AMES, IA 50010-8063
(515) 233-9087
(515) 233-6409
Mailing address
1110 BUCKEYE AVENUE, AMES, IA 50010-8063
(515) 233-9087
(515) 233-6409
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
06757
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0451641
—
IA
05
—
0451658
—
IA
01
—
37766
WELLMARK PROVIDER #
IA
01
—
I14239
IOWA MEDICARE, GROUP
IA
Enumeration date
04/26/2006
Last updated
04/09/2008
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