MEDICARE: MCKITTRICK CHIROPRACTIC INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	460	MT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	42411	OTHER	MT	BCBS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1275755266
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MCKITTRICK CHIROPRACTIC INC.

Provider Business Mailing Address
First Line	:	2212 BROADWATER AVE
Second Line	:	SUITE D
City	:	BILLINGS
State	:	MT
Zip	:	59102-4779
Country	:	US
Telephone Number	:	406-652-3553
Fax Number	:

Provider Business Practice Location Address
First Line	:	2212 BROADWATER AVE
Second Line	:	SUITE D
City	:	BILLINGS
State	:	MT
Zip	:	59102-4779
Country	:	US
Telephone Number	:	406-652-3553
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. TRENT D MCKITTRICK
Credential	:	D.C.
Telephone Number	:	406-652-3553

Provider Enumeration Date	:	05/02/2007
Last Update Date	:	08/22/2020

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