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:
Health care specialties
Specialty | Code | License # | 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 14 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1629076435 | NPPES |
Other | 4995423 | BCBS | |
MEDICAID | 7601960 | BCBS |
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