Provider Demographics
NPI:1083932883
Name:ROBERTS FAMILY CHIROPRACTIC CENTER INC.
Entity Type:Organization
Organization Name:ROBERTS FAMILY CHIROPRACTIC CENTER INC.
Other - Org Name:DMX IMAGING OF MONTANA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GILBERT
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:ROBERTS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:406-363-2111
Mailing Address - Street 1:803 N 2ND ST
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:MT
Mailing Address - Zip Code:59840-2111
Mailing Address - Country:US
Mailing Address - Phone:406-363-2111
Mailing Address - Fax:406-363-0836
Practice Address - Street 1:803 N 2ND ST
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:MT
Practice Address - Zip Code:59840-2111
Practice Address - Country:US
Practice Address - Phone:406-363-2111
Practice Address - Fax:406-363-0836
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-04
Last Update Date:2010-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT756111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MTM000004380Medicare PIN