Provider Demographics
NPI:1427148972
Name:CARLSON, DELANEY J (DC)
Entity type:Individual
Prefix:DR
First Name:DELANEY
Middle Name:J
Last Name:CARLSON
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7935 MT HIGHWAY 35
Mailing Address - Street 2:SUITE 202
Mailing Address - City:BIGFORK
Mailing Address - State:MT
Mailing Address - Zip Code:59911-5709
Mailing Address - Country:US
Mailing Address - Phone:406-837-6881
Mailing Address - Fax:406-837-6962
Practice Address - Street 1:7935 MT HIGHWAY 35
Practice Address - Street 2:SUITE 202
Practice Address - City:BIGFORK
Practice Address - State:MT
Practice Address - Zip Code:59911-5709
Practice Address - Country:US
Practice Address - Phone:406-837-6881
Practice Address - Fax:406-837-6962
Is Sole Proprietor?:No
Enumeration Date:2006-10-13
Last Update Date:2009-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT1070111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT41303OtherBLUE CROSS BLUE SHIELD
MT000084778Medicare ID - Type Unspecified