Provider Demographics
NPI:1740334929
Name:BITTNER CHIROPRACTIC INC.
Entity type:Organization
Organization Name:BITTNER CHIROPRACTIC INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:FRANK
Authorized Official - Last Name:BITTNER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:507-637-3005
Mailing Address - Street 1:1251 E BRIDGE ST
Mailing Address - Street 2:P.O. BOX 314
Mailing Address - City:REDWOOD FALLS
Mailing Address - State:MN
Mailing Address - Zip Code:56283-1901
Mailing Address - Country:US
Mailing Address - Phone:507-637-3005
Mailing Address - Fax:507-627-3007
Practice Address - Street 1:1251 E BRIDGE ST
Practice Address - Street 2:
Practice Address - City:REDWOOD FALLS
Practice Address - State:MN
Practice Address - Zip Code:56283-1901
Practice Address - Country:US
Practice Address - Phone:507-637-3005
Practice Address - Fax:507-627-3007
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1612111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN230097OtherACN GROUP
MN94265OtherMEDICA
MN47004BIOtherBLUECROSS & BLUE SHIELD
MNT65314Medicare UPIN