JACK VICTOR LUNDBOHM (NPI# 1275632234) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275632234 |
| Entity Type | Individual |
| Full Name | JACK VICTOR LUNDBOHM |
| Practice Address |
317 2nd St Nw Ste A Roseau MN 56751 |
| Practice Telephone | 2184632992 |
| Practice Fax Number | 2184631229 |
| Mailing Telephone | 2184632992 |
| Mailing Fax Number | 2184631229 |
| Enumeration Date | 2006-09-22 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 111N00000X | Chiropractor | 1792 | MN | Chiropractic Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003212465 | Jack Lundbohm | Chiropractor | 39 6th St W Unit B, Columbia Falls, MT 59912-3602 | 2014-11-13 |
| Street Address |
317 2ND ST NW STE A |
| City | ROSEAU |
| State | MN |
| Zip Code | 56751 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841739885 | David Simmons | Pharmacist | 715 Delmore Drive, Roseau, MN 56751 | 2017-02-22 |
| 1770841082 | Amber Rohde | Physical Therapist | 44371 350 St., Roseau, MN 56751 | 2012-04-25 |
| 1558390336 | Marianne Renae Foldesi | Physician Assistant | 711 Delmore Drive, Roseau, MN 56751 | 2006-07-02 |
| 1871679456 | Roseau/warroad Eye Clinic, P.a. | Optometrist | 306 N Main, Roseau, MN 56751 | 2006-10-27 |
| 1194935619 | Ageless Care,inc | Home Health | 702 7th St Sw, Roseau, MN 56751-0000 | 2007-05-23 |
| 1235176033 | Lorris Galen Vatnsdal II | Dentist | 205a 2nd Ave Nw, Roseau, MN 56751-1007 | 2006-06-01 |
| 1336204536 | Lorris G. Vatnsdal, Ltd. | Dentist | 205a 2nd Ave Nw, Roseau, MN 56751-1007 | 2006-12-27 |
| 1164584322 | Cynthia Faye Drost-sandy | Dentist | 205a 2nd Ave Nw, Roseau, MN 56751-1007 | 2006-12-14 |
| 1952478489 | Robert Frank Larson | Dentist | 201 4th Ave Nw, Roseau, MN 56751-1033 | 2006-11-29 |
| 1063892313 | Jon Hallie | Dentist | 201 4th Ave Nw, Roseau, MN 56751-1033 | 2015-06-02 |
| Find all providers in zip 56751 | ||||
| Taxonomy Code | 111N00000X |
| Grouping | Chiropractic Providers |
| Classification | Chiropractor |
| A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336145341 | Lew Anthony Erickson | Chiropractor | 1013 3rd St Ne, Roseau, MN 56751-1209 | 2005-06-23 |
| 1669610416 | Matthew Lew Erickson | Chiropractor | 1013 3rd St Ne, Roseau, MN 56751-1209 | 2009-02-02 |
| 1982886024 | Lew A. Erickson, Ltd | Chiropractor | 1013 3rd St Ne, Roseau, MN 56751-1209 | 2007-11-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609477785 | Samantha Nielsen | Chiropractor | 482 Snelling Ave S, Saint Paul, MN 55116-1501 | 2020-11-04 |
| 1063013340 | Plymouth Chirocenter LLC | Chiropractor | 3900 Vinewood Ln N Ste 19, Plymouth, MN 55441-1155 | 2020-11-04 |
| 1093315855 | Today Evolved Ltd. | Chiropractor | 321 Broadway Ave, St Paul Park, MN 55071-1841 | 2020-10-29 |
| 1417556796 | Nicole Frogner Koshiol | Chiropractor | 11901 Highway 65 Ne, Blaine, MN 55434-3911 | 2020-10-19 |
| 1417554627 | Austin Montgomery Gray | Chiropractor | 4229 West Frontage Rd Nw, Suite 4, Rochester, MN 55901 | 2020-10-01 |
| 1659988848 | Amanda Shorter | Chiropractor | 669 Winnetka Ave N Ste 202, Golden Valley, MN 55427-4576 | 2020-09-30 |
| 1700499308 | Devries Spine Care Pllc | Chiropractor | 4748 Chicago Ave Ste 10, Minneapolis, MN 55407-4311 | 2020-08-25 |
| 1316559024 | Lashonda Jung | Chiropractor | 8112 Minnetonka Blvd, St Louis Park, MN 55426-3022 | 2020-08-24 |
| 1699384198 | Arrow Health Chiropractic, P.a. | Chiropractor | 1000 Nicollet Mall # 260, Minneapolis, MN 55403-2542 | 2020-07-30 |
| 1366051278 | Altrui Sc | Chiropractor | 11985 Technology Dr Ste 120, Eden Prairie, MN 55344-3614 | 2020-07-27 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on JACK VICTOR LUNDBOHM.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.