Abc Chiropractic PC
Organization Active NPI Chiropractor · Fargo, ND
NPI 1942604145 · NPPES record last updated Oct 16, 2014
Key facts
- NPI
- 1942604145
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Chiropractor 111N00000X
- License
- 682 (ND)
- Legal business name
- ABC CHIROPRACTIC PC
- Practice address
- 826 Park Dr S
Fargo, ND 58103-5336 - Phone
- (701) 730-7079
- NPI assigned
- Oct 16, 2014
- Organization subpart
- No
Authorized official
- Name
- Jonathan Walter Deitz, D.C.
- Title
- President
- Phone
- (701) 730-7079
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor |
111N00000X | 682 | ND | Yes |
Addresses
Primary practice location
826 Park Dr S
Fargo, ND 58103-5336
Mailing address
826 Park Dr S
Fargo, ND 58103-5336
Phone (701) 730-7079
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 11334 | Medicaid | ND |
Other providers in Fargo, ND
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 16, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.