Provider Demographics
NPI:1962486779
Name:TERNUS, JESSE MICHAEL (DC)
Entity Type:Individual
Prefix:DR
First Name:JESSE
Middle Name:MICHAEL
Last Name:TERNUS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:7850 RIVERDALE DR NW
Mailing Address - Street 2:SUITE D
Mailing Address - City:RAMSEY
Mailing Address - State:MN
Mailing Address - Zip Code:55303-7215
Mailing Address - Country:US
Mailing Address - Phone:763-712-5986
Mailing Address - Fax:763-712-3916
Practice Address - Street 1:7850 RIVERDALE DR NW
Practice Address - Street 2:SUITE D
Practice Address - City:RAMSEY
Practice Address - State:MN
Practice Address - Zip Code:55303-7215
Practice Address - Country:US
Practice Address - Phone:763-712-5986
Practice Address - Fax:763-712-3916
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MN3863111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN82D29BAOtherBCBS
MNU79057Medicare ID - Type Unspecified