Provider Demographics
NPI:1538346002
Name:SIX CHIROPRACTIC, P.C.
Entity type:Organization
Organization Name:SIX CHIROPRACTIC, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:A
Authorized Official - Last Name:SIX
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:406-452-6929
Mailing Address - Street 1:1424 10TH AVE S
Mailing Address - Street 2:
Mailing Address - City:GREAT FALLS
Mailing Address - State:MT
Mailing Address - Zip Code:59405-2624
Mailing Address - Country:US
Mailing Address - Phone:406-452-6929
Mailing Address - Fax:406-452-1605
Practice Address - Street 1:1424 10TH AVE S
Practice Address - Street 2:
Practice Address - City:GREAT FALLS
Practice Address - State:MT
Practice Address - Zip Code:59405-2624
Practice Address - Country:US
Practice Address - Phone:406-452-6929
Practice Address - Fax:406-452-1605
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-28
Last Update Date:2008-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT609111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty