Provider Demographics
NPI:1316472848
Name:JURGENS CHIROPRACTIC,P.C.
Entity type:Organization
Organization Name:JURGENS CHIROPRACTIC,P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DAN
Authorized Official - Middle Name:CLAYTON
Authorized Official - Last Name:JURGENS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:858-547-8913
Mailing Address - Street 1:9855 ERMA RD
Mailing Address - Street 2:STE 104
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92131-3001
Mailing Address - Country:US
Mailing Address - Phone:858-547-8913
Mailing Address - Fax:
Practice Address - Street 1:9855 ERMA RD
Practice Address - Street 2:STE 104
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92131-3001
Practice Address - Country:US
Practice Address - Phone:858-547-8913
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-21
Last Update Date:2017-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty