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General NPI Number Information
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NPI Number | 1336385947
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Entity Type | Organization
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Legal Business Name | JORGENSEN CHIROPRACTIC CARE LLC
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Dates
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Enumeration Date | 01/02/2009
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Last Update Date | 05/04/2022
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Provider Practice Location Address
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Address Line | 110 S SHERMAN AVE
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City | NORTH PLATTE
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State | NE
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Zip | 69101-4913
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Country | US
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Telephone | 308-534-1870
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Fax | 308-534-1871
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Provider Business Mailing Address
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Address Line | 110 S SHERMAN AVE
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City | NORTH PLATTE
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State | NE
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Zip | 69101-4913
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Country | US
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Telephone | 308-534-1870
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Fax | 308-534-1871
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Authorized Official
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Title or Position | CHIROPRACTOR
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Name | DR. JERED ANTHONY JORGENSEN
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Credential | D.C.
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Telephone | 308-534-1870
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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 | 639
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License Number State | NE
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