| NPI | 1376021600 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JORDAN BAGLEY Owner 406-587-8446 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor |
| Additional Taxonomies | 225100000X Physical Therapist |
| Enumeration Date | 2018-07-30 |
| Last Update Date | 2018-07-30 |