Bludorn, Jerad Robert

Bludorn, Jerad Robert is an sole proprietor health care provider with primary practice located at 505 Main Ave , Lake Norden SD 57248-0252. He recently has only one registered license in Chiropractic Providers / Chiropractor, which is considered as his primary health care specialty. Bludorn, Jerad Robert can be contacted via phone (605) 785-3900.

Contact Information

Primary practice address
505 Main Ave Lake Norden SD 57248-0252
Phone: (605) 785-3900
Fax: (605) 785-3908
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Chiropractic Providers / Chiropractor 111N00000X 1025 South Dakota

Profile Details

NPI number 1629076435
LBN Legal business name Bludorn, Jerad Robert
Credentials Doctor of Chiropractic (DC)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 14th, 2005
Last updated Nov 17th, 2011 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1629076435 NPPES
Other 4995423 BCBS
MEDICAID 7601960 BCBS

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