| Marquardt Chiropractic Clinic | |
|
1203 Mount Ave Missoula MT 59801-5601 | |
| (406) 543-5251 | |
| Not Available |
| Full Name | Marquardt Chiropractic Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 1203 Mount Ave, Missoula, Montana |
| Authorized Official Name and Position | Mage R Lee (OWNER) |
| Authorized Official Contact | 4065435251 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Marquardt Chiropractic Clinic 1203 Mount Ave Missoula MT 59801-5601 Ph: (406) 543-5251 | Marquardt Chiropractic Clinic 1203 Mount Ave Missoula MT 59801-5601 Ph: (406) 543-5251 |
| NPI Number | 1952817439 |
|---|---|
| Provider Enumeration Date | 12/20/2017 |
| Last Update Date | 03/20/2018 |
| Medicare PECOS PAC ID | 7810257938 |
|---|---|
| Medicare Enrollment ID | O20180212000952 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952817439 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| 261QH0100X | Clinic/center - Health Service | (Montana) | Secondary |
| Provider Name | Mage R Lee |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1356858179 PECOS PAC ID: 9436411071 Enrollment ID: I20180328000940 |
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