Provider Demographics
NPI:1982180188
Name:INTEGRATED CHIROPRACTIC LLC
Entity Type:Organization
Organization Name:INTEGRATED CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PART-OWNER/CHIROPRACTOR
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:
Authorized Official - Last Name:BJORKLUND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:970-744-6788
Mailing Address - Street 1:931 MOUNTAIN AVE
Mailing Address - Street 2:
Mailing Address - City:BERTHOUD
Mailing Address - State:CO
Mailing Address - Zip Code:80513-1321
Mailing Address - Country:US
Mailing Address - Phone:970-744-6788
Mailing Address - Fax:
Practice Address - Street 1:931 MOUNTAIN AVE
Practice Address - Street 2:
Practice Address - City:BERTHOUD
Practice Address - State:CO
Practice Address - Zip Code:80513-1321
Practice Address - Country:US
Practice Address - Phone:970-744-6788
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-11
Last Update Date:2018-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCHR.0006778111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty