Provider Demographics
NPI:1619571270
Name:CRABTREE, CHASE JAMES (DC)
Entity Type:Individual
Prefix:
First Name:CHASE
Middle Name:JAMES
Last Name:CRABTREE
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 1:212 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:STEVENSVILLE
Mailing Address - State:MT
Mailing Address - Zip Code:59870-2111
Mailing Address - Country:US
Mailing Address - Phone:406-777-1048
Mailing Address - Fax:406-777-1038
Practice Address - Street 1:212 MAIN ST
Practice Address - Street 2:
Practice Address - City:STEVENSVILLE
Practice Address - State:MT
Practice Address - Zip Code:59870-2111
Practice Address - Country:US
Practice Address - Phone:406-777-1048
Practice Address - Fax:406-777-1038
Is Sole Proprietor?:No
Enumeration Date:2020-11-24
Last Update Date:2022-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTCHI-CHI-LIC-6732111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MTM011017032Medicaid