Provider Demographics
NPI:1093715732
Name:BITTNER, JEFFREY FRANK (DC)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:FRANK
Last Name:BITTNER
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:PO BOX 314
Mailing Address - Street 2:
Mailing Address - City:REDWOOD FALLS
Mailing Address - State:MN
Mailing Address - Zip Code:56283-0314
Mailing Address - Country:US
Mailing Address - Phone:507-637-3005
Mailing Address - Fax:507-627-3007
Practice Address - Street 1:1251 E BRIDGE ST
Practice Address - Street 2:
Practice Address - City:REDWOOD FALLS
Practice Address - State:MN
Practice Address - Zip Code:56283-1901
Practice Address - Country:US
Practice Address - Phone:507-637-3005
Practice Address - Fax:507-627-3007
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1612111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN44-40139OtherMEDICA
MN47004BIOtherBCBS
FM230097OtherCHIROCARE
MN44-40139OtherMEDICA
MN47004BIOtherBCBS