Individual
DR. JAY JOSEPH FITZGERALD
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
109 1ST. ST. SW, WAGNER, SD 57380
(605) 384-5419
(605) 384-5410
Mailing address
109 1ST. ST. SW, PO BOX 758, WAGNER, SD 57380
(605) 384-5419
(605) 384-5410
Taxonomy
Speciality
Code
Description
License number
State
111NS0005X
Sports Physician Chiropractor
Primary
840
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7604080
—
SD
Enumeration date
01/23/2006
Last updated
07/08/2007
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