Provider Demographics
NPI:1295728814
Name:POPP, ANTHONY J JR (DC)
Entity type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:J
Last Name:POPP
Suffix:JR
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 1:5 S MERIDIAN RD
Mailing Address - Street 2:
Mailing Address - City:KALISPELL
Mailing Address - State:MT
Mailing Address - Zip Code:59901-4263
Mailing Address - Country:US
Mailing Address - Phone:406-755-1001
Mailing Address - Fax:406-755-1862
Practice Address - Street 1:5 S MERIDIAN RD
Practice Address - Street 2:
Practice Address - City:KALISPELL
Practice Address - State:MT
Practice Address - Zip Code:59901-4263
Practice Address - Country:US
Practice Address - Phone:406-755-1001
Practice Address - Fax:406-755-1862
Is Sole Proprietor?:No
Enumeration Date:2005-08-30
Last Update Date:2007-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT910CHI111N00000X
IDCHIA885111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
42181OtherBCBS
MTDA7886OtherRAILROAD MEDICARE -GROUP
MTP0007206OtherRAILROAD MEDICARE
MTP0007206OtherRAILROAD MEDICARE