Jacklitch Chiropractic Clinic

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

2434 Issued in MN

Legal business name

JACKLITCH CHIROPRACTIC CLINIC

Practice address

645 Lake Ave S
Paynesville, MN 56362-1736

Phone

(320) 243-7412

NPI assigned

Jul 30, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Randal Jacklitch

Title

Owner

Phone

(320) 243-7412

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1185753600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1191456000000",
    "number": "1235329970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "645 LAKE AVE S",
            "city": "PAYNESVILLE",
            "state": "MN",
            "postal_code": "563621736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "645 LAKE AVE S",
            "city": "PAYNESVILLE",
            "state": "MN",
            "postal_code": "563621736",
            "telephone_number": "320-243-7412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACKLITCH CHIROPRACTIC CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-30",
        "last_updated": "2007-10-04",
        "status": "A",
        "authorized_official_last_name": "JACKLITCH",
        "authorized_official_first_name": "RANDAL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "320-243-7412",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "2434",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• GRX Holdings LLC
• Lori Kay Haag, OTR/L, CLT-LANA
• Kurt Alan Habben, M.D.
• Theresa Hacklander, CMT
• Marla Mae Hartmann
• Randal Joseph Jacklitch, D.C.
• Ella Veronica Johnson, OTD, OTR/L
• Terry Scott Johnson, RPH
• Michael Kihiu, CNP
• Lisa Joy Klein-Conrad

• Chiropractor in Paynesville, MN
• Providers in Paynesville, MN by specialty
• Chiropractor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.