Healthcare Provider Details
I. General information
NPI: 1033063060
Provider Name (Legal Business Name): HEADWATERS CHIROPRACTIC & WELLNESS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/25/2026
Last Update Date: 02/25/2026
Certification Date: 02/25/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1185 FREMONT ST STE 7
BOZEMAN MT
59718-2657
US
IV. Provider business mailing address
1185 FREMONT ST STE 7
BOZEMAN MT
59718-2657
US
V. Phone/Fax
- Phone: 507-210-1227
- Fax:
- Phone: 507-210-1227
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 111N00000X |
| Taxonomy | Chiropractor |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
MORGAN
KAYE WATERSTRAAT
WOODS
Title or Position: OWNER/MANAGER
Credential: DC
Phone: 507-210-1227