Provider Demographics
NPI:1407999022
Name:SANDNESS-RIEGER, JODI KAE (DC)
Entity Type:Individual
Prefix:DR
First Name:JODI
Middle Name:KAE
Last Name:SANDNESS-RIEGER
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:PO BOX 722
Mailing Address - Street 2:
Mailing Address - City:LISBON
Mailing Address - State:ND
Mailing Address - Zip Code:58054-0722
Mailing Address - Country:US
Mailing Address - Phone:701-683-5337
Mailing Address - Fax:701-683-0096
Practice Address - Street 1:15 - 11TH AVE W
Practice Address - Street 2:
Practice Address - City:LISBON
Practice Address - State:ND
Practice Address - Zip Code:58054
Practice Address - Country:US
Practice Address - Phone:701-683-5337
Practice Address - Fax:701-683-0096
Is Sole Proprietor?:No
Enumeration Date:2007-02-14
Last Update Date:2011-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND553111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND12688OtherBCBS
ND12688OtherBCBS
NDU44238Medicare UPIN