Provider Demographics
NPI:1447641329
Name:JUNGELS, CAITLYN (LAT, DC)
Entity type:Individual
Prefix:
First Name:CAITLYN
Middle Name:
Last Name:JUNGELS
Suffix:
Gender:F
Credentials:LAT, DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1916 CYPRESS CIR
Mailing Address - Street 2:
Mailing Address - City:SARTELL
Mailing Address - State:MN
Mailing Address - Zip Code:56377-1683
Mailing Address - Country:US
Mailing Address - Phone:218-340-9158
Mailing Address - Fax:
Practice Address - Street 1:436 GREAT OAK DR
Practice Address - Street 2:
Practice Address - City:WAITE PARK
Practice Address - State:MN
Practice Address - Zip Code:56387-2505
Practice Address - Country:US
Practice Address - Phone:132-043-7171
Practice Address - Fax:320-278-8223
Is Sole Proprietor?:No
Enumeration Date:2015-02-12
Last Update Date:2023-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
2255A2300X
MN27512255A2300X
MN6773111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer