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General NPI Number Information
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NPI Number | 1952547978
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Entity Type | Organization
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Legal Business Name | GRAFTON CHIROPRACTIC CLINIC, P.C.
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Dates
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Enumeration Date | 12/22/2008
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Last Update Date | 11/06/2023
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Provider Practice Location Address
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Address Line | 808 W 12TH ST
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City | GRAFTON
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State | ND
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Zip | 58237-2144
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Country | US
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Telephone | 701-352-0400
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Fax |
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Provider Business Mailing Address
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Address Line | 728 HILL AVE
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City | GRAFTON
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State | ND
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Zip | 58237-1448
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Country | US
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Telephone | 701-352-0400
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Fax |
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Authorized Official
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Title or Position | CHIROPRACTOR/OWNER
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Name | DR. JONATHAN E JELINEK
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Credential | D.C.
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Telephone | 701-520-4630
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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 | 760
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License Number State | ND
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