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General NPI Number Information
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NPI Number | 1811183916
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Entity Type | Organization
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Legal Business Name | EUREKA FAMILY CHIROPRACTIC P.C.
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Dates
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Enumeration Date | 09/21/2007
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Last Update Date | 02/17/2010
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Provider Practice Location Address
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Address Line | 110 DEWEY AVE
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City | EUREKA
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State | MT
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Zip | 59917
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Country | US
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Telephone | 406-297-2999
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Fax | 406-297-7999
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Provider Business Mailing Address
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Address Line | PO BOX 1557
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City | EUREKA
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State | MT
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Zip | 59917-1557
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Country | US
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Telephone | 406-297-2999
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Fax | 406-297-7999
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JENNY M. KOMAC
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Credential | D.C.
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Telephone | 406-297-2999
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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 | 919
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License Number State | MT
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