Organization
JORGENSON FAMILY CHIROPRACTIC, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRETT JORGENSON D.C. (CHIROPRACTOR)
(701) 282-6110
Entity
Organization
Contact information
Practice address
1201 13TH AVE E, WEST FARGO, ND 58078-3378
(701) 282-6110
(701) 282-6113
Mailing address
1201 13TH AVE E, WEST FARGO, ND 58078-3378
(701) 282-6110
(701) 282-6113
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
613
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05761001
BLUE SHIELD GROUP #
ND
05
—
12046
—
ND
01
—
382S1JO
BLUE SHIELD MN GROUP #
MN
Enumeration date
01/08/2007
Last updated
03/03/2008
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