Healthcare Provider Details
I. General information
NPI: 1467923342
Provider Name (Legal Business Name): MADE TO MOVE CHIROPRACTIC, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/17/2018
Last Update Date: 02/02/2021
Certification Date: 02/02/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1050 HELENA AVE STE 5
HELENA MT
59601-3573
US
IV. Provider business mailing address
1050 HELENA AVE STE 5
HELENA MT
59601-3573
US
V. Phone/Fax
- Phone: 406-594-4849
- Fax:
- Phone: 406-594-4849
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 111N00000X |
| Taxonomy | Chiropractor |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261Q00000X |
| Taxonomy | Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
AARON
B
JONES
Title or Position: OWNER
Credential: DC
Phone: 406-594-4849