Fitzgerald, Jay Joseph

Fitzgerald, Jay Joseph is an individual health care provider with primary practice located at 109 1St. St. Sw , Wagner SD 57380. He recently has only one registered license in Chiropractic Providers / Sports Physician, which is considered as his primary health care specialty. Fitzgerald, Jay Joseph can be contacted via phone (605) 384-5419.

Contact Information

Primary practice address
109 1St. St. Sw Wagner SD 57380
Phone: (605) 384-5419
Fax: (605) 384-5410
Website:
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Health care specialties

SpecialtyCodeLicense #State
Chiropractic Providers / Sports Physician 111NS0005X 840 South Dakota

Profile Details

NPI number 1447220603
LBN Legal business name Fitzgerald, Jay Joseph
Credentials Doctor of Chiropractic (DC)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 23rd, 2006
Last updated Jul 8th, 2007 - about 17 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 1447220603 NPPES
South Dakota MEDICAID 7604080

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