Provider Demographics
NPI:1639296122
Name:MCNULTY, WILLIAM J (DC)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:J
Last Name:MCNULTY
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3946 US HIGHWAY 93
Mailing Address - Street 2:
Mailing Address - City:STEVENSVILLE
Mailing Address - State:MT
Mailing Address - Zip Code:59870
Mailing Address - Country:US
Mailing Address - Phone:406-777-5630
Mailing Address - Fax:406-777-0061
Practice Address - Street 1:3946 US HWY 93 S
Practice Address - Street 2:
Practice Address - City:STEVENSVILLE
Practice Address - State:MT
Practice Address - Zip Code:59870-6425
Practice Address - Country:US
Practice Address - Phone:406-777-5630
Practice Address - Fax:406-777-0061
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-22
Last Update Date:2007-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT732111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor