Provider Demographics
NPI:1205865920
Name:NIETER, ANTHONY JAMES (DC)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:JAMES
Last Name:NIETER
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 1:33 VILLAGE LOOP RD UNIT C
Mailing Address - Street 2:
Mailing Address - City:KALISPELL
Mailing Address - State:MT
Mailing Address - Zip Code:59901-2948
Mailing Address - Country:US
Mailing Address - Phone:406-257-4001
Mailing Address - Fax:406-257-0359
Practice Address - Street 1:33 VILLAGE LOOP RD UNIT C
Practice Address - Street 2:
Practice Address - City:KALISPELL
Practice Address - State:MT
Practice Address - Zip Code:59901-2948
Practice Address - Country:US
Practice Address - Phone:406-257-4001
Practice Address - Fax:406-257-0359
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-03
Last Update Date:2023-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT1039CHI111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0164713Medicaid
MT0164713Medicaid
MT496175Medicare UPIN
MT000083450Medicare PIN