Provider Demographics
NPI:1477810257
Name:BJERKE, ERIC EDWARD (DC)
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:EDWARD
Last Name:BJERKE
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 1:801 SE 6TH AVE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33483-5185
Mailing Address - Country:US
Mailing Address - Phone:561-808-7388
Mailing Address - Fax:561-808-7387
Practice Address - Street 1:801 SE 6TH AVE STE 102
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33483-5185
Practice Address - Country:US
Practice Address - Phone:561-808-7388
Practice Address - Fax:561-808-7387
Is Sole Proprietor?:No
Enumeration Date:2012-04-18
Last Update Date:2020-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH10630111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLGR199YMedicare PIN