MEDICARE: DR. SHANE ALBERT CUTTING D.C.

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	1047 CHI	MT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	000040923	OTHER	MT	BLUE CROSS BLUE SHIELD
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1871546556
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SHANE ALBERT CUTTING D.C.

Provider Business Mailing Address
First Line	:	2419 MULLAN RD
Second Line	:	SUITE A
City	:	MISSOULA
State	:	MT
Zip	:	59808-1827
Country	:	US
Telephone Number	:	406-543-1955
Fax Number	:	406-543-1506

Provider Business Practice Location Address
First Line	:	2419 MULLAN RD
Second Line	:	SUITE A
City	:	MISSOULA
State	:	MT
Zip	:	59808-1827
Country	:	US
Telephone Number	:	406-543-1955
Fax Number	:	406-543-1506

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/17/2006
Last Update Date	:	07/09/2007

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