Provider Demographics
NPI:1598530891
Name:SUNDIAL CHIROPRACTIC P.L.L.C.
Entity Type:Organization
Organization Name:SUNDIAL CHIROPRACTIC P.L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:JASON
Authorized Official - Middle Name:
Authorized Official - Last Name:JORGENSEN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:952-270-8161
Mailing Address - Street 1:18068 EVENER WAY
Mailing Address - Street 2:
Mailing Address - City:EDEN PRAIRIE
Mailing Address - State:MN
Mailing Address - Zip Code:55346-4270
Mailing Address - Country:US
Mailing Address - Phone:952-270-8161
Mailing Address - Fax:
Practice Address - Street 1:5757 SANIBEL DR STE 11
Practice Address - Street 2:
Practice Address - City:MINNETONKA
Practice Address - State:MN
Practice Address - Zip Code:55343-4110
Practice Address - Country:US
Practice Address - Phone:952-939-0297
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-17
Last Update Date:2023-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty