Provider Demographics
NPI:1982186607
Name:JORDAN E SAJOVIC, PC
Entity Type:Organization
Organization Name:JORDAN E SAJOVIC, PC
Other - Org Name:ELITE CHIROPRACTIC & INJURY REHAB
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JORDAN
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:SAJOVIC
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:971-409-2092
Mailing Address - Street 1:2150 COMMERCIAL ST SE BSMT SUITE
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97302-5379
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2150 COMMERCIAL ST SE BSMT SUITE
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97302-5379
Practice Address - Country:US
Practice Address - Phone:971-409-2092
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-29
Last Update Date:2018-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR5036111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty