Provider Demographics
NPI:1003977265
Name:SAILER, JEFFREY JOHN (DC)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:JOHN
Last Name:SAILER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:234 PINE CONE RD STE B
Mailing Address - Street 2:
Mailing Address - City:SARTELL
Mailing Address - State:MN
Mailing Address - Zip Code:56377-2504
Mailing Address - Country:US
Mailing Address - Phone:320-253-5255
Mailing Address - Fax:320-253-5260
Practice Address - Street 1:234 PINECONE RD STE B
Practice Address - Street 2:
Practice Address - City:SARTELL
Practice Address - State:MN
Practice Address - Zip Code:56377-2504
Practice Address - Country:US
Practice Address - Phone:320-253-5255
Practice Address - Fax:320-253-5260
Is Sole Proprietor?:No
Enumeration Date:2006-12-12
Last Update Date:2011-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN4676111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNV05749Medicare UPIN
MN350003425Medicare PIN