Provider Demographics
NPI:1689875833
Name:SCHARNWEBER, JESSE OTTO (DC)
Entity Type:Individual
Prefix:
First Name:JESSE
Middle Name:OTTO
Last Name:SCHARNWEBER
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 1:2722 BILLINGS AVE
Mailing Address - Street 2:
Mailing Address - City:HELENA
Mailing Address - State:MT
Mailing Address - Zip Code:59601-9767
Mailing Address - Country:US
Mailing Address - Phone:406-443-7000
Mailing Address - Fax:
Practice Address - Street 1:2722 BILLINGS AVE
Practice Address - Street 2:
Practice Address - City:HELENA
Practice Address - State:MT
Practice Address - Zip Code:59601-9767
Practice Address - Country:US
Practice Address - Phone:406-443-7000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-29
Last Update Date:2008-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT1160111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT41763OtherBLUE CROSS BLUE SHIELD