Jurgensen, David Thomas
Jurgensen, David Thomas is an sole proprietor health care provider with primary practice located at 114 W State St , Mauston WI 53948-1354. He recently has only one registered license in Chiropractic Providers / Chiropractor, which is considered as his primary health care specialty. Jurgensen, David Thomas can be contacted via phone (608) 847-6194.Contact Information
Primary practice address
114 W State St
Mauston WI 53948-1354
Phone: (608) 847-6194
Fax: (608) 847-4374
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Chiropractic Providers / Chiropractor | 111N00000X | 2500-012 | Wisconsin |
Profile Details
| NPI number | 1174651061 |
|---|---|
| LBN Legal business name | Jurgensen, David Thomas |
| Credentials | Doctor of Chiropractic (DC) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Mar 1st, 2007 |
| 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1174651061 | NPPES |
| Wisconsin | MEDICAID | 38844600 |
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