Organization
JONATHAN CHIROPRACTIC PC
Active
Other names
Wellness Dimensions
Organization subpart
No
Provider details
NPI number
Authorized official
JONATHAN W DEITZ DC (PRESIDENT)
70122228322
Entity
Organization
Contact information
Practice address
1051 E INTERSTATE AVE, BISMARCK, ND 58503-0551
(701) 222-8322
(701) 222-8397
Mailing address
1051 E INTERSTATE AVE, BISMARCK, ND 58503-0551
(701) 222-8322
(701) 222-8397
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
682
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
13403
—
ND
01
—
1818
BLUE CROSS BLUE SHIELD
ND
01
—
DE7888
RAILROAD MEDICARE
ND
Enumeration date
01/08/2007
Last updated
11/07/2007
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