Provider Demographics
NPI:1669799417
Name:LUJAN, JENA (DC)
Entity type:Individual
Prefix:DR
First Name:JENA
Middle Name:
Last Name:LUJAN
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 1:909 W MAIN ST
Mailing Address - Street 2:SUITE 2
Mailing Address - City:MANCHESTER
Mailing Address - State:IA
Mailing Address - Zip Code:52057-1522
Mailing Address - Country:US
Mailing Address - Phone:563-920-7131
Mailing Address - Fax:
Practice Address - Street 1:909 W MAIN ST
Practice Address - Street 2:SUITE 2
Practice Address - City:MANCHESTER
Practice Address - State:IA
Practice Address - Zip Code:52057-1522
Practice Address - Country:US
Practice Address - Phone:563-920-7131
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-05-03
Last Update Date:2014-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038011673111N00000X
IA072232111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor