Healthcare Provider Details

I. General information

NPI: 1982706511
Provider Name (Legal Business Name): NICHOLAS R SAMS D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/03/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 27TH ST W STE C1
BILLINGS MT
59102-8602
US

IV. Provider business mailing address

50 27TH ST W STE C1
BILLINGS MT
59102-8602
US

V. Phone/Fax

Practice location:
  • Phone: 406-325-1701
  • Fax: 406-656-0651
Mailing address:
  • Phone: 406-325-1701
  • Fax: 406-656-0651

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number1099
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: