| NPI | 1053716860 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY R MITCHELL Onwer 406-969-3805 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: MT 1017) |
| Additional Taxonomies | 111NR0400X Chiropractor, Rehabilitation (Licence: MT 1017) |
| Enumeration Date | 2014-10-23 |
| Last Update Date | 2014-10-23 |