Provider Demographics
NPI:1467986083
Name:HUNZIKER, KIMBERLY JILL (D,C,, LAC)
Entity Type:Individual
Prefix:DR
First Name:KIMBERLY
Middle Name:JILL
Last Name:HUNZIKER
Suffix:
Gender:F
Credentials:D,C,, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1086 BAXTER LN E
Mailing Address - Street 2:
Mailing Address - City:BOZEMAN
Mailing Address - State:MT
Mailing Address - Zip Code:59718-9782
Mailing Address - Country:US
Mailing Address - Phone:406-579-1991
Mailing Address - Fax:
Practice Address - Street 1:1086 BAXTER LN E
Practice Address - Street 2:
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59718-9782
Practice Address - Country:US
Practice Address - Phone:406-579-1991
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-20
Last Update Date:2017-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT780111N00000X
MT50238171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor
No111N00000XChiropractic ProvidersChiropractor