Provider Demographics
NPI:1245325539
Name:WALTERS-TERRITO, MISTY ELAINE (DC)
Entity type:Individual
Prefix:DR
First Name:MISTY
Middle Name:ELAINE
Last Name:WALTERS-TERRITO
Suffix:
Gender:F
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 603
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA FALLS
Mailing Address - State:MT
Mailing Address - Zip Code:59912-0603
Mailing Address - Country:US
Mailing Address - Phone:406-752-2282
Mailing Address - Fax:
Practice Address - Street 1:2640 HWY 2 E
Practice Address - Street 2:SUITE B
Practice Address - City:KALISPELL
Practice Address - State:MT
Practice Address - Zip Code:59901
Practice Address - Country:US
Practice Address - Phone:406-752-2282
Practice Address - Fax:406-752-2282
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT1120111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT41473OtherBC/BS