Doctor Name: | DR. MICHAEL D JACKLITCH |
NPI Number: | 1477674794 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | D.C. |
License Number: | 1381 |
Business Practice Address: | 320 Dakota Ave Wahpeton, ND - 580754515 |
Business Phone Number: | 7016425600 |
Business Fax Number: | 7016428354 |
Mailing Address: | 320 Dakota Ave, WAHPETON |
State: | ND |
Postal Code: | 580754515 |
Phone Number: | 7016425600 |
Fax Number: | 7016428354 |
NPI Enumeration Date: | 04/03/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 111N00000X |
License Number: | 1381 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | MN |
Taxonomy Type: | Chiropractic Providers |
Taxonomy Classification: | Chiropractor |
Taxonomy Specialization: | |
Taxonomy Definition: | 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. |