Provider Demographics
NPI:1215252408
Name:GROTE, KRISTIN ELIZABETH (DC)
Entity type:Individual
Prefix:DR
First Name:KRISTIN
Middle Name:ELIZABETH
Last Name:GROTE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1730 DELAWARE AVE
Mailing Address - Street 2:
Mailing Address - City:BUTTE
Mailing Address - State:MT
Mailing Address - Zip Code:59701-5200
Mailing Address - Country:US
Mailing Address - Phone:406-490-7013
Mailing Address - Fax:
Practice Address - Street 1:1730 DELAWARE AVE
Practice Address - Street 2:
Practice Address - City:BUTTE
Practice Address - State:MT
Practice Address - Zip Code:59701-5200
Practice Address - Country:US
Practice Address - Phone:406-490-7013
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-03-31
Last Update Date:2010-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT1206111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor