Provider Demographics
NPI:1417143744
Name:JURGELEWICZ, MICHAEL BLAIR (DC)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:BLAIR
Last Name:JURGELEWICZ
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 1:9 WILFRED DR
Mailing Address - Street 2:
Mailing Address - City:YARDLEY
Mailing Address - State:PA
Mailing Address - Zip Code:19067-2050
Mailing Address - Country:US
Mailing Address - Phone:215-504-7200
Mailing Address - Fax:215-504-7201
Practice Address - Street 1:206 FLORAL VALE BLVD
Practice Address - Street 2:
Practice Address - City:YARDLEY
Practice Address - State:PA
Practice Address - Zip Code:19067-5524
Practice Address - Country:US
Practice Address - Phone:215-504-7200
Practice Address - Fax:215-504-7201
Is Sole Proprietor?:No
Enumeration Date:2007-09-20
Last Update Date:2009-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC009842111N00000X
PAAJ009655111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor