Provider Demographics
NPI:1093764680
Name:ECKMANN, MARY A (DC)
Entity Type:Individual
Prefix:DR
First Name:MARY
Middle Name:A
Last Name:ECKMANN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 N MONTANA AVE
Mailing Address - Street 2:STE. B 2
Mailing Address - City:HELENA
Mailing Address - State:MT
Mailing Address - Zip Code:59601-3845
Mailing Address - Country:US
Mailing Address - Phone:406-442-1442
Mailing Address - Fax:406-442-3424
Practice Address - Street 1:900 N MONTANA AVE
Practice Address - Street 2:STE. B 2
Practice Address - City:HELENA
Practice Address - State:MT
Practice Address - Zip Code:59601-3845
Practice Address - Country:US
Practice Address - Phone:406-442-1442
Practice Address - Fax:406-442-3424
Is Sole Proprietor?:No
Enumeration Date:2006-05-09
Last Update Date:2013-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT726111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0000162097Medicaid
MT350049811OtherRAILROAD MEDICARE
MT350049811OtherRAILROAD MEDICARE
MTU35778Medicare UPIN