| Advanced Chiropractic Inc. | |
|
720 2nd St E Kalispell MT 59901-4678 | |
| (406) 257-7463 | |
| (406) 257-7466 |
| Full Name | Advanced Chiropractic Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 720 2nd St E, Kalispell, Montana |
| Authorized Official Name and Position | Thomas P Fullerton (OWNER) |
| Authorized Official Contact | 4062577463 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Advanced Chiropractic Inc. 720 2nd St E Kalispell MT 59901-4678 Ph: (406) 257-7463 | Advanced Chiropractic Inc. 720 2nd St E Kalispell MT 59901-4678 Ph: (406) 257-7463 |
| NPI Number | 1710218219 |
|---|---|
| Provider Enumeration Date | 01/22/2010 |
| Last Update Date | 02/12/2010 |
| Medicare PECOS PAC ID | 6608910716 |
|---|---|
| Medicare Enrollment ID | O20100212000287 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710218219 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 383 (Montana) | Primary |
| Provider Name | Thomas P Fullerton |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1104997071 PECOS PAC ID: 7618011727 Enrollment ID: I20100212000280 |
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