Healthcare Provider Details

I. General information

NPI: 1841303450
Provider Name (Legal Business Name): JOHN ARLEN BJERKE DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/16/2006
Last Update Date: 07/29/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

820 NORTH MAIN ST
VIROQUA WI
54665
US

IV. Provider business mailing address

820 NORTH MAIN ST
VIROQUA WI
54665
US

V. Phone/Fax

Practice location:
  • Phone: 608-637-7177
  • Fax: 608-637-7177
Mailing address:
  • Phone: 608-637-7177
  • Fax: 608-637-7177

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number1490012
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: