Healthcare Provider Details
I. General information
NPI: 1902924731
Provider Name (Legal Business Name): BERISH CHIROPRACTIC CLINIC PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/27/2007
Last Update Date: 10/14/2010
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1690 RIMROCK RD STE G
BILLINGS MT
59102-0700
US
IV. Provider business mailing address
1690 RIMROCK RD STE G
BILLINGS MT
59102-0700
US
V. Phone/Fax
- Phone: 406-259-4908
- Fax: 406-252-0040
- Phone: 406-259-4908
- Fax: 406-252-0040
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 111N00000X |
| Taxonomy | Chiropractor |
| License Number | 465 |
| License Number State | MT |
VIII. Authorized Official
Name: DR.
KARLENE
H
BERISH
Title or Position: PRESIDENT
Credential: D.C.
Phone: 406-259-4908