Provider Demographics
NPI:1790054336
Name:ENGEL, JEFFREY MICHAEL (DC)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:MICHAEL
Last Name:ENGEL
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 1:1001 SW HIGGINS AVE STE 102
Mailing Address - Street 2:
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59803-1340
Mailing Address - Country:US
Mailing Address - Phone:406-317-1014
Mailing Address - Fax:406-317-1014
Practice Address - Street 1:1001 SW HIGGINS AVE STE 102
Practice Address - Street 2:
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59803
Practice Address - Country:US
Practice Address - Phone:406-317-1014
Practice Address - Fax:406-258-0620
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-28
Last Update Date:2018-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT1277111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor