Provider Demographics
NPI:1275719734
Name:CHAPMAN FAMILY CHIROPRACTIC CARE PC
Entity Type:Organization
Organization Name:CHAPMAN FAMILY CHIROPRACTIC CARE PC
Other - Org Name:PROADJUSTER CHIROPRACTIC CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:JAY
Authorized Official - Last Name:CHAPMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:406-721-5780
Mailing Address - Street 1:1526 S RESERVE ST
Mailing Address - Street 2:
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59801-4756
Mailing Address - Country:US
Mailing Address - Phone:406-721-5780
Mailing Address - Fax:406-721-6487
Practice Address - Street 1:1526 S RESERVE ST
Practice Address - Street 2:
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59801-4756
Practice Address - Country:US
Practice Address - Phone:406-721-5780
Practice Address - Fax:406-721-6487
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-15
Last Update Date:2008-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT514111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT1366505737Medicare PIN