Provider Demographics
NPI:1932290921
Name:BJERRE, ERIK SOREN (DC)
Entity Type:Individual
Prefix:MR
First Name:ERIK
Middle Name:SOREN
Last Name:BJERRE
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 1:112 DOUGLAS AVE
Mailing Address - Street 2:SUITE 5
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02908-3257
Mailing Address - Country:US
Mailing Address - Phone:401-421-7414
Mailing Address - Fax:401-421-7415
Practice Address - Street 1:112 DOUGLAS AVE
Practice Address - Street 2:SUITE 5
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02908-3257
Practice Address - Country:US
Practice Address - Phone:401-421-7414
Practice Address - Fax:401-421-7415
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIDCP00505111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor