Provider Demographics
NPI:1831675875
Name:BIERTZER, JORDAN ALEXANDRA (DC)
Entity Type:Individual
Prefix:
First Name:JORDAN
Middle Name:ALEXANDRA
Last Name:BIERTZER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:559 EDGEWOOD PL
Mailing Address - Street 2:
Mailing Address - City:WHITEFISH
Mailing Address - State:MT
Mailing Address - Zip Code:59937-2358
Mailing Address - Country:US
Mailing Address - Phone:406-730-8569
Mailing Address - Fax:
Practice Address - Street 1:559 EDGEWOOD PL
Practice Address - Street 2:
Practice Address - City:WHITEFISH
Practice Address - State:MT
Practice Address - Zip Code:59937-2358
Practice Address - Country:US
Practice Address - Phone:406-730-8569
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-12
Last Update Date:2020-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTCHI-CHI-LIC-5086111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor