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General NPI Number Information
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NPI Number | 1588145494
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Entity Type | Organization
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Legal Business Name | TREASURE STATE CHIROPRACTIC PC
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Dates
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Enumeration Date | 08/28/2018
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Last Update Date | 11/05/2018
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Provider Practice Location Address
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Address Line | 7935 MT HIGHWAY 35 STE 201
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City | BIGFORK
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State | MT
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Zip | 59911-5711
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Country | US
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Telephone | 406-420-2811
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Fax |
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Provider Business Mailing Address
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Address Line | 7935 MT HIGHWAY 35 STE 201
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City | BIGFORK
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State | MT
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Zip | 59911-5711
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Country | US
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Telephone | 406-420-2811
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MEGAN SHOULTZ
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Credential |
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Telephone | 406-420-2811
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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 |
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License Number State |
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