Provider Demographics
NPI:1326199688
Name:WILHELM, JONATHAN M (DC)
Entity Type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:M
Last Name:WILHELM
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 1:8757 JACKRABBIT LN
Mailing Address - Street 2:SUITE A
Mailing Address - City:BELGRADE
Mailing Address - State:MT
Mailing Address - Zip Code:59714-7900
Mailing Address - Country:US
Mailing Address - Phone:406-388-9915
Mailing Address - Fax:406-388-9916
Practice Address - Street 1:8757 JACKRABBIT LN
Practice Address - Street 2:SUITE A
Practice Address - City:BELGRADE
Practice Address - State:MT
Practice Address - Zip Code:59714-7900
Practice Address - Country:US
Practice Address - Phone:406-388-9915
Practice Address - Fax:406-388-9916
Is Sole Proprietor?:No
Enumeration Date:2007-01-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT1085111N00000X, 111NR0400X, 111NS0005X, 111NT0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered111N00000XChiropractic ProvidersChiropractor
Not Answered111NR0400XChiropractic ProvidersChiropractorRehabilitation
Not Answered111NS0005XChiropractic ProvidersChiropractorSports Physician
Not Answered111NT0100XChiropractic ProvidersChiropractorThermography
Provider Identifiers
StateIdentifier IDID TypeIssuer
MTV02939Medicare UPIN