Individual
DR. JEROD LYNN OCHSENDORF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC, CCSP, ATC
Contact information
Practice address
114 5TH AVE W, ALEXANDRIA, MN 56308-1304
(320) 762-2055
Mailing address
114 5TH AVE W, ALEXANDRIA, MN 56308-1304
(320) 762-2055
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
4768
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
260441800
—
MN
01
—
350004518
MEDICARE PTAN
MN
01
—
77G43OC
BCBS 'AWARE' PROVIDER
MN
Enumeration date
11/15/2006
Last updated
08/30/2016
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