Provider Demographics
NPI:1851651319
Name:ADVANCED SPINAL FITNESS CHIROPRACTIC PLLC
Entity type:Organization
Organization Name:ADVANCED SPINAL FITNESS CHIROPRACTIC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:LANCE
Authorized Official - Middle Name:JAY
Authorized Official - Last Name:DOPPLER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:406-459-5126
Mailing Address - Street 1:932 ASPEN ST
Mailing Address - Street 2:
Mailing Address - City:HELENA
Mailing Address - State:MT
Mailing Address - Zip Code:59601-0704
Mailing Address - Country:US
Mailing Address - Phone:406-443-5510
Mailing Address - Fax:
Practice Address - Street 1:932 ASPEN ST
Practice Address - Street 2:
Practice Address - City:HELENA
Practice Address - State:MT
Practice Address - Zip Code:59601-0704
Practice Address - Country:US
Practice Address - Phone:406-443-5510
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-17
Last Update Date:2012-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTCHI-CHI-LIC-1840111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty