Provider Demographics
NPI:1508143793
Name:JURGENS CHIROPRACTIC
Entity Type:Organization
Organization Name:JURGENS CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DANNY
Authorized Official - Middle Name:
Authorized Official - Last Name:JURGENS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:858-547-8913
Mailing Address - Street 1:12090 SCRIPPS SUMMIT DR
Mailing Address - Street 2:SUITE C
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92131-4602
Mailing Address - Country:US
Mailing Address - Phone:858-547-8913
Mailing Address - Fax:
Practice Address - Street 1:12090 SCRIPPS SUMMIT DR
Practice Address - Street 2:SUITE C
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92131-4602
Practice Address - Country:US
Practice Address - Phone:858-547-8913
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-16
Last Update Date:2011-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC27678111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty