=====================================================
General NPI Number Information
=====================================================
NPI Number | 1699802140
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CHIROPRACTIC FIRST OF BILLINGS, P.C.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/28/2007
-----------------------------------------------------
Last Update Date | 01/06/2016
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 10 AVANTA WAY SUITE 1
-----------------------------------------------------
City | BILLINGS
-----------------------------------------------------
State | MT
-----------------------------------------------------
Zip | 59102-6873
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 406-652-6700
-----------------------------------------------------
Fax | 406-294-6701
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 10 AVANTA WAY SUITE 1
-----------------------------------------------------
City | BILLINGS
-----------------------------------------------------
State | MT
-----------------------------------------------------
Zip | 59102-6873
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 406-652-6700
-----------------------------------------------------
Fax | 406-294-6701
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | DR. DALE W WILLIAMS
-----------------------------------------------------
Credential | D.O.
-----------------------------------------------------
Telephone | 406-652-6700
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 111N00000X
-----------------------------------------------------
Taxonomy Name | Chiropractor
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------