Provider Demographics
NPI:1497809552
Name:SPEISER, DALE A (DC)
Entity Type:Individual
Prefix:DR
First Name:DALE
Middle Name:A
Last Name:SPEISER
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 1:304 MILWAUKEE AVE
Mailing Address - Street 2:
Mailing Address - City:DEER LODGE
Mailing Address - State:MT
Mailing Address - Zip Code:59722-1085
Mailing Address - Country:US
Mailing Address - Phone:406-846-9545
Mailing Address - Fax:406-846-9545
Practice Address - Street 1:304 MILWAUKEE AVE
Practice Address - Street 2:
Practice Address - City:DEER LODGE
Practice Address - State:MT
Practice Address - Zip Code:59722-1085
Practice Address - Country:US
Practice Address - Phone:406-846-9545
Practice Address - Fax:406-846-9545
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT1080CHI111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN1001XChiropractic ProvidersChiropractorNutrition
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT1080CHIOtherCHIROPRACTIC LICENCE
UT287218-1202OtherCHIROPRACTIC LICENCE
OH2514OtherCHIROPRACTIC LICENCE
WA2658OtherCHIROPRACTIC LICENCE