| NPI | 1528479417 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN BUSHMAN Manager 406-969-4213 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111NS0005X Chiropractor, Sports Physician (Licence: MT CHI-CHI-2913) |
| Enumeration Date | 2014-05-13 |
| Last Update Date | 2014-06-02 |