Provider Demographics
NPI:1285861856
Name:ALTHANS, KATHARINE C (DC)
Entity type:Individual
Prefix:
First Name:KATHARINE
Middle Name:C
Last Name:ALTHANS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:KATHARINE
Other - Middle Name:E
Other - Last Name:CRANDALL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:PO BOX 561
Mailing Address - Street 2:
Mailing Address - City:THREE FORKS
Mailing Address - State:MT
Mailing Address - Zip Code:59752-0561
Mailing Address - Country:US
Mailing Address - Phone:406-570-8361
Mailing Address - Fax:
Practice Address - Street 1:2135 CHARLOTTE ST STE 1
Practice Address - Street 2:
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59718-2741
Practice Address - Country:US
Practice Address - Phone:406-219-4085
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-22
Last Update Date:2024-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT1221111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0000395564Medicaid
MTM011003142Medicare PIN