Healthcare Provider Details

I. General information

NPI: 1215079140
Provider Name (Legal Business Name): WHITEHALL CHIROPRACTIC PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/14/2007
Last Update Date: 03/03/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

511 W LEGION AVE
WHITEHALL MT
59759-0547
US

IV. Provider business mailing address

PO BOX 547
WHITEHALL MT
59759-0547
US

V. Phone/Fax

Practice location:
  • Phone: 406-287-3217
  • Fax: 406-287-3217
Mailing address:
  • Phone: 406-287-3217
  • Fax: 406-287-3217

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number727
License Number StateMT

VIII. Authorized Official

Name: DR. KATHERINE K MEYER
Title or Position: PRESIDENT
Credential: DC
Phone: 406-287-3217