Provider Demographics
NPI:1003972571
Name:DARR, WADE ANTHONY (DC)
Entity Type:Individual
Prefix:MR
First Name:WADE
Middle Name:ANTHONY
Last Name:DARR
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 1:2616 W MAIN ST STE B
Mailing Address - Street 2:
Mailing Address - City:BOZEMAN
Mailing Address - State:MT
Mailing Address - Zip Code:59718
Mailing Address - Country:US
Mailing Address - Phone:406-586-5810
Mailing Address - Fax:406-586-5583
Practice Address - Street 1:2616 W MAIN ST STE B
Practice Address - Street 2:
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59718
Practice Address - Country:US
Practice Address - Phone:406-586-5810
Practice Address - Fax:406-586-5583
Is Sole Proprietor?:No
Enumeration Date:2006-12-29
Last Update Date:2007-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT643CHI111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor