Provider Demographics
NPI:1720073661
Name:OTTUN COX, JOELEEN (DC)
Entity type:Individual
Prefix:
First Name:JOELEEN
Middle Name:
Last Name:OTTUN COX
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:JOELEEN
Other - Middle Name:
Other - Last Name:OTTUN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:1643 24TH ST W
Mailing Address - Street 2:SUITE 203
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59102-2677
Mailing Address - Country:US
Mailing Address - Phone:406-259-9383
Mailing Address - Fax:406-294-2822
Practice Address - Street 1:1643 24TH ST W
Practice Address - Street 2:SUITE 203
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59102-2677
Practice Address - Country:US
Practice Address - Phone:406-259-9383
Practice Address - Fax:406-294-2822
Is Sole Proprietor?:No
Enumeration Date:2005-09-16
Last Update Date:2014-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT955111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0164356Medicaid
MT40153OtherBLUE CROSS/BLUE SHIELD
MT0164359Medicaid
MT40153OtherBLUE CROSS/BLUE SHIELD
MTU83189Medicare UPIN
MT0164356Medicaid
MT0164359Medicaid