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General NPI Number Information
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NPI Number | 1538346002
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Entity Type | Organization
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Legal Business Name | SIX CHIROPRACTIC, P.C.
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Dates
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Enumeration Date | 01/28/2008
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Last Update Date | 01/28/2008
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Provider Practice Location Address
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Address Line | 1424 10TH AVE S
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City | GREAT FALLS
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State | MT
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Zip | 59405-2624
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Country | US
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Telephone | 406-452-6929
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Fax | 406-452-1605
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Provider Business Mailing Address
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Address Line | 1424 10TH AVE S
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City | GREAT FALLS
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State | MT
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Zip | 59405-2624
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Country | US
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Telephone | 406-452-6929
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Fax | 406-452-1605
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Authorized Official
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Title or Position | OWNER
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Name | MR. TIMOTHY A SIX
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Credential | D.C.
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Telephone | 406-452-6929
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 609
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License Number State | MT
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