Provider Demographics
NPI:1154408458
Name:GUNLOGSON, JENNIFER ERIN (DC)
Entity type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:ERIN
Last Name:GUNLOGSON
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:519 S 1ST ST
Mailing Address - Street 2:
Mailing Address - City:MONTEVIDEO
Mailing Address - State:MN
Mailing Address - Zip Code:56265-2103
Mailing Address - Country:US
Mailing Address - Phone:320-269-3211
Mailing Address - Fax:320-269-9465
Practice Address - Street 1:519 S 1ST ST
Practice Address - Street 2:
Practice Address - City:MONTEVIDEO
Practice Address - State:MN
Practice Address - Zip Code:56265-2103
Practice Address - Country:US
Practice Address - Phone:320-269-3211
Practice Address - Fax:320-269-9465
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN4741111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor