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General NPI Number Information
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NPI Number | 1811169915
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Entity Type | Organization
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Legal Business Name | WHITEFISH CHIROPRACTIC CENTER PC
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Dates
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Enumeration Date | 03/28/2008
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Last Update Date | 04/03/2013
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Provider Practice Location Address
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Address Line | 5938 HWY 93 S
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City | WHITEFISH
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State | MT
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Zip | 59937-8415
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Country | US
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Telephone | 406-862-2121
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Fax | 406-863-9301
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Provider Business Mailing Address
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Address Line | PO BOX 5114
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City | WHITEFISH
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State | MT
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Zip | 59937-5114
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Country | US
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Telephone | 406-862-2121
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Fax | 406-863-9301
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Authorized Official
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Title or Position | DR.
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Name | DR. RYAN M WIGNESS
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Credential | D.C.
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Telephone | 406-862-2121
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | 1048
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License Number State | MT
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