Provider Demographics
NPI:1003040627
Name:DJP CHIROPRACTIC LLC
Entity Type:Organization
Organization Name:DJP CHIROPRACTIC LLC
Other - Org Name:BOZEMAN FAMILY CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:PFAU
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:406-586-5252
Mailing Address - Street 1:1351 STONERIDGE DR
Mailing Address - Street 2:SUITE B
Mailing Address - City:BOZEMAN
Mailing Address - State:MT
Mailing Address - Zip Code:59718-7079
Mailing Address - Country:US
Mailing Address - Phone:406-586-5252
Mailing Address - Fax:406-586-5454
Practice Address - Street 1:1351 STONERIDGE DR
Practice Address - Street 2:SUITE B
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59718-7079
Practice Address - Country:US
Practice Address - Phone:406-586-5252
Practice Address - Fax:406-586-5454
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-11
Last Update Date:2009-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT1195111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty