Healthcare Provider Details

I. General information

NPI: 1477810257
Provider Name (Legal Business Name): ERIC EDWARD BJERKE DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/18/2012
Last Update Date: 05/06/2020
Certification Date: 05/06/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 SE 6TH AVE STE 102
DELRAY BEACH FL
33483-5185
US

IV. Provider business mailing address

801 SE 6TH AVE SUITE 102
DELRAY BEACH FL
33483-5185
US

V. Phone/Fax

Practice location:
  • Phone: 561-808-7388
  • Fax: 561-808-7387
Mailing address:
  • Phone: 561-808-7388
  • Fax: 561-808-7387

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCH10630
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: