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General NPI Number Information
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NPI Number | 1790838126
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Entity Type | Organization
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Legal Business Name | GREAT FALLS CHIROPRACTIC CLINIC, P.L.L.C
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Dates
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Enumeration Date | 01/19/2007
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Last Update Date | 02/08/2011
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Provider Practice Location Address
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Address Line | 400 13TH AVE S SUITE 104
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City | GREAT FALLS
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State | MT
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Zip | 59405-4300
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Country | US
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Telephone | 406-727-1660
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Fax | 406-452-9094
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Provider Business Mailing Address
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Address Line | 400 13TH AVE S SUITE 104
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City | GREAT FALLS
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State | MT
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Zip | 59405-4300
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Country | US
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Telephone | 406-727-1660
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Fax | 406-452-9094
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Authorized Official
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Title or Position | OWNER
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Name | DR. MARK T STOEBE
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Credential | D.C.
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Telephone | 406-727-1660
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NX0800X
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Taxonomy Name | Orthopedic Chiropractor
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License Number | 473
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License Number State | MT
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