Provider Demographics
NPI:1760868293
Name:ROJO, ANTHONY MICHAEL (DC)
Entity Type:Individual
Prefix:
First Name:ANTHONY
Middle Name:MICHAEL
Last Name:ROJO
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:PO BOX 2926
Mailing Address - Street 2:
Mailing Address - City:KALISPELL
Mailing Address - State:MT
Mailing Address - Zip Code:59903-2926
Mailing Address - Country:US
Mailing Address - Phone:406-407-3923
Mailing Address - Fax:
Practice Address - Street 1:770 W RESERVE DR STE 3
Practice Address - Street 2:
Practice Address - City:KALISPELL
Practice Address - State:MT
Practice Address - Zip Code:59901-2158
Practice Address - Country:US
Practice Address - Phone:406-752-5555
Practice Address - Fax:406-534-7030
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-06
Last Update Date:2020-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTCHI-CHI-LIC-3572111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor