| 15th Street Chiropractic Pc | |
|
222 15th St S Suite C Great Falls MT 59405-2459 | |
| (406) 771-1222 | |
| (406) 771-1225 |
| Full Name | 15th Street Chiropractic Pc |
|---|---|
| Speciality | Clinic/center |
| Location | 222 15th St S, Great Falls, Montana |
| Authorized Official Name and Position | Mark W Hertenstein (OWNER) |
| Authorized Official Contact | 4067711222 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| 15th Street Chiropractic Pc 222 15th St S Suite C Great Falls MT 59405-2459 Ph: (406) 771-1222 | 15th Street Chiropractic Pc 222 15th St S Suite C Great Falls MT 59405-2459 Ph: (406) 771-1222 |
| NPI Number | 1073786653 |
|---|---|
| Provider Enumeration Date | 04/03/2008 |
| Last Update Date | 04/03/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073786653 | NPI | - | NPPES |
| 0164398 | Medicaid | MT | |
| 40763 | Other | MT | BLUE CROSS/BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 537 (Montana) | Primary |
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