Healthcare Provider Details

I. General information

NPI: 1154556058
Provider Name (Legal Business Name): GARTH CHIROPRACTIC, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/20/2009
Last Update Date: 05/20/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6475 HWY 93 S STE 56
WHITEFISH MT
59937-8265
US

IV. Provider business mailing address

6475 HWY 93 S STE 56
WHITEFISH MT
59937-8265
US

V. Phone/Fax

Practice location:
  • Phone: 406-862-6142
  • Fax:
Mailing address:
  • Phone: 406-862-6142
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number791
License Number StateMT

VIII. Authorized Official

Name: RAYMOND H GARTH II
Title or Position: PRESIDENT
Credential: D.C., DACAN
Phone: 406-862-9100