Provider Demographics
NPI:1114220175
Name:JORDE, ERICA LYNN (DC)
Entity Type:Individual
Prefix:
First Name:ERICA
Middle Name:LYNN
Last Name:JORDE
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:P.O BOX 156
Mailing Address - Street 2:
Mailing Address - City:TOWNER
Mailing Address - State:ND
Mailing Address - Zip Code:58788-0156
Mailing Address - Country:US
Mailing Address - Phone:170-153-7200
Mailing Address - Fax:
Practice Address - Street 1:#2 3RD ST SW
Practice Address - Street 2:
Practice Address - City:TOWNER
Practice Address - State:ND
Practice Address - Zip Code:58788
Practice Address - Country:US
Practice Address - Phone:701-537-2007
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-12-14
Last Update Date:2010-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND870111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor