Provider Demographics
NPI:1013281716
Name:HULTGREN CHIROPRACTORS PC
Entity Type:Organization
Organization Name:HULTGREN CHIROPRACTORS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RANDALL
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:HULTGREN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:406-259-1250
Mailing Address - Street 1:944 AVENUE B
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59102-3346
Mailing Address - Country:US
Mailing Address - Phone:406-259-1250
Mailing Address - Fax:406-259-5043
Practice Address - Street 1:944 AVE B
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59102-3346
Practice Address - Country:US
Practice Address - Phone:406-259-1250
Practice Address - Fax:406-259-5043
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-28
Last Update Date:2012-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT431111NX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NX0800XChiropractic ProvidersChiropractorOrthopedicGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT160329Medicare PIN
MTT60135Medicare UPIN