Provider Demographics
NPI:1033301379
Name:DELANEY J. CARLSON, D.C. LIMITED
Entity Type:Organization
Organization Name:DELANEY J. CARLSON, D.C. LIMITED
Other - Org Name:CARLSON CHIROPRACTIC OF BIGFORK
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DELANEY
Authorized Official - Middle Name:J
Authorized Official - Last Name:CARLSON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:406-837-6881
Mailing Address - Street 1:7935 MT HIGHWAY 35
Mailing Address - Street 2:SUITE 202
Mailing Address - City:BIGFORK
Mailing Address - State:MT
Mailing Address - Zip Code:59911-5709
Mailing Address - Country:US
Mailing Address - Phone:406-837-6881
Mailing Address - Fax:406-837-6962
Practice Address - Street 1:7935 MT HIGHWAY 35
Practice Address - Street 2:SUITE 202
Practice Address - City:BIGFORK
Practice Address - State:MT
Practice Address - Zip Code:59911-5709
Practice Address - Country:US
Practice Address - Phone:406-837-6881
Practice Address - Fax:406-837-6962
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-10
Last Update Date:2009-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT1070111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT000041303OtherBLUE CROSS BLUE SHIELD
MTV05627Medicare UPIN
MT000084778Medicare PIN