Healthcare Provider Details

I. General information

NPI: 1831647825
Provider Name (Legal Business Name): JULIA J PURVIS PROFESSIONAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/19/2016
Last Update Date: 02/16/2024
Certification Date: 02/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1308 12TH AVE S
GREAT FALLS MT
59405-4607
US

IV. Provider business mailing address

1308 12TH AVE S
GREAT FALLS MT
59405-4607
US

V. Phone/Fax

Practice location:
  • Phone: 406-453-8885
  • Fax: 406-453-8887
Mailing address:
  • Phone: 406-453-8885
  • Fax: 406-453-8887

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCHI-CHI-LIC-543
License Number StateMT

VIII. Authorized Official

Name: CAITLIN WALTER
Title or Position: PRESIDENT
Credential: DC
Phone: 406-453-8885