Provider Demographics
NPI:1346693421
Name:CHAPPELL, CAROL LEE (DC)
Entity type:Individual
Prefix:DR
First Name:CAROL
Middle Name:LEE
Last Name:CHAPPELL
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 1:1276 N 15TH AVE
Mailing Address - Street 2:101
Mailing Address - City:BOZEMAN
Mailing Address - State:MT
Mailing Address - Zip Code:59715-3289
Mailing Address - Country:US
Mailing Address - Phone:406-580-9987
Mailing Address - Fax:
Practice Address - Street 1:1276 N 15TH AVE
Practice Address - Street 2:101
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59715-3289
Practice Address - Country:US
Practice Address - Phone:406-580-9987
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-13
Last Update Date:2016-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTCHI-CHI-LIC-4017111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor