Provider Demographics
NPI:1871823518
Name:AGUAYO CHIROPRACTIC & WELLNESS INC
Entity Type:Organization
Organization Name:AGUAYO CHIROPRACTIC & WELLNESS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JASON
Authorized Official - Middle Name:
Authorized Official - Last Name:AGUAYO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:406-294-5777
Mailing Address - Street 1:2212 BROADWATER AVE
Mailing Address - Street 2:SUITE D
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59102-4779
Mailing Address - Country:US
Mailing Address - Phone:406-294-5777
Mailing Address - Fax:406-294-5778
Practice Address - Street 1:2212 BROADWATER AVE
Practice Address - Street 2:SUITE D
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59102-4779
Practice Address - Country:US
Practice Address - Phone:406-294-5777
Practice Address - Fax:406-294-5778
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-31
Last Update Date:2009-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT1132111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty