| NPI | 1871825604 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DUSTIN G TAVENNER Chiropractic Physician 406-531-1244 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: IL 038011196) |
| Enumeration Date | 2010-02-03 |
| Last Update Date | 2010-02-03 |