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General NPI Number Information
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NPI Number | 1275793838
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Entity Type | Organization
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Legal Business Name | JERRY A PAULSON DC INC
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Dates
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Enumeration Date | 06/16/2008
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Last Update Date | 11/18/2010
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Provider Practice Location Address
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Address Line | 7671 E BUENA VISTA DR
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City | PRESCOTT VALLEY
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State | AZ
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Zip | 86314-5532
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Country | US
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Telephone | 928-710-0019
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Fax |
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Provider Business Mailing Address
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Address Line | 7671 E BUENA VISTA DR
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City | PRESCOTT VALLEY
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State | AZ
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Zip | 86314-5532
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Country | US
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Telephone | 928-533-3311
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Fax |
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Authorized Official
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Title or Position | CHIROPRACTOR
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Name | DR. JERRY ARNOLD PAULSON
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Credential | D.C.
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Telephone | 928-533-3311
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 6030
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License Number State | AZ
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