Healthcare Provider Details

I. General information

NPI: 1871726224
Provider Name (Legal Business Name): ANDREA LYNN JORDHEIM D.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/02/2009
Last Update Date: 12/29/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2501 BLICHMAN AVE SUITE 110
GRAND JUNCTION CO
81505-1092
US

IV. Provider business mailing address

2501 BLICHMAN AVE SUITE 110
GRAND JUNCTION CO
81505-1092
US

V. Phone/Fax

Practice location:
  • Phone: 970-812-5559
  • Fax: 888-972-6051
Mailing address:
  • Phone: 970-812-5559
  • Fax: 888-972-6051

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111NN1001X
TaxonomyNutrition Chiropractor
License NumberCHR0007006
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code111NT0100X
TaxonomyThermography Chiropractor
License NumberCHR0007006
License Number StateCO
# 3
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCHR0007006
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: