Provider Demographics
NPI:1376007187
Name:STILSON, JUSTIN CURTIS (DC)
Entity Type:Individual
Prefix:
First Name:JUSTIN
Middle Name:CURTIS
Last Name:STILSON
Suffix:
Gender:M
Credentials:DC
Other - Prefix:DR
Other - First Name:JUSTIN
Other - Middle Name:CURTIS
Other - Last Name:STILSON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:JUSTIN STILSON DC
Mailing Address - Street 1:1301 12TH AVE S STE 203
Mailing Address - Street 2:
Mailing Address - City:GREAT FALLS
Mailing Address - State:MT
Mailing Address - Zip Code:59405-4600
Mailing Address - Country:US
Mailing Address - Phone:406-770-3800
Mailing Address - Fax:
Practice Address - Street 1:1301 12TH AVE S STE 203
Practice Address - Street 2:
Practice Address - City:GREAT FALLS
Practice Address - State:MT
Practice Address - Zip Code:59405-4600
Practice Address - Country:US
Practice Address - Phone:406-770-3800
Practice Address - Fax:406-770-3802
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-25
Last Update Date:2019-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTCHI-CHI-LIC-5586111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor