Provider Demographics
NPI:1427394527
Name:LUNDBY UPPER CERVICAL CHIROPRACTIC, P.C.
Entity Type:Organization
Organization Name:LUNDBY UPPER CERVICAL CHIROPRACTIC, P.C.
Other - Org Name:UPPER CERVICAL HEALTH CENTERS OF AMERICA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:LUNDBY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:701-595-4869
Mailing Address - Street 1:1830 E CENTURY AVE
Mailing Address - Street 2:SUITE 7
Mailing Address - City:BISMARCK
Mailing Address - State:ND
Mailing Address - Zip Code:58503-0639
Mailing Address - Country:US
Mailing Address - Phone:701-751-4848
Mailing Address - Fax:701-751-5041
Practice Address - Street 1:1830 E CENTURY AVE STE 8
Practice Address - Street 2:
Practice Address - City:BISMARCK
Practice Address - State:ND
Practice Address - Zip Code:58503-0639
Practice Address - Country:US
Practice Address - Phone:701-751-4848
Practice Address - Fax:701-751-5041
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-17
Last Update Date:2024-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND914111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND914OtherSTATE LICENSE NUMBER