Healthcare Provider Details

I. General information

NPI: 1043544240
Provider Name (Legal Business Name): JON LAWRENCE BJARNASON D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/22/2009
Last Update Date: 03/09/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1720 WESTMINSTER ST STE 100
DENTON TX
76205-7831
US

IV. Provider business mailing address

1720 WESTMINSTER ST STE 100
DENTON TX
76205-7831
US

V. Phone/Fax

Practice location:
  • Phone: 940-566-8605
  • Fax:
Mailing address:
  • Phone: 940-566-8605
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number31389
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number11684
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: