Provider Demographics
NPI:1790183192
Name:NELSON, BJORN CARR (DC)
Entity Type:Individual
Prefix:DR
First Name:BJORN
Middle Name:CARR
Last Name:NELSON
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 1:1930 NORTH AVE
Mailing Address - Street 2:
Mailing Address - City:SPEARFISH
Mailing Address - State:SD
Mailing Address - Zip Code:57783-2913
Mailing Address - Country:US
Mailing Address - Phone:605-641-6040
Mailing Address - Fax:605-642-4409
Practice Address - Street 1:1930 NORTH AVE
Practice Address - Street 2:
Practice Address - City:SPEARFISH
Practice Address - State:SD
Practice Address - Zip Code:57783-2913
Practice Address - Country:US
Practice Address - Phone:605-641-6040
Practice Address - Fax:605-642-4409
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-17
Last Update Date:2014-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD1263111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor