Healthcare Provider Details

I. General information

NPI: 1649626714
Provider Name (Legal Business Name): B CHIROPRACTIC, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/09/2016
Last Update Date: 05/09/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3027 MT HIGHWAY 83 N L
SEELEY LAKE MT
59868-8620
US

IV. Provider business mailing address

3027 MT HIGHWAY 83 N L
SEELEY LAKE MT
59868-8620
US

V. Phone/Fax

Practice location:
  • Phone: 406-677-3617
  • Fax: 406-677-3618
Mailing address:
  • Phone: 406-677-3617
  • Fax: 406-677-3618

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number1276
License Number StateMT

VIII. Authorized Official

Name: DR. ANDREW L BOHLMAN
Title or Position: PRESIDENT
Credential: D.C.
Phone: 775-742-5256