Provider Demographics
NPI:1649626714
Name:B CHIROPRACTIC, P.C.
Entity type:Organization
Organization Name:B CHIROPRACTIC, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:L
Authorized Official - Last Name:BOHLMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:775-742-5256
Mailing Address - Street 1:3027 MT HIGHWAY 83 N
Mailing Address - Street 2:L
Mailing Address - City:SEELEY LAKE
Mailing Address - State:MT
Mailing Address - Zip Code:59868-8620
Mailing Address - Country:US
Mailing Address - Phone:406-677-3617
Mailing Address - Fax:406-677-3618
Practice Address - Street 1:3027 MT HIGHWAY 83 N
Practice Address - Street 2:L
Practice Address - City:SEELEY LAKE
Practice Address - State:MT
Practice Address - Zip Code:59868-8620
Practice Address - Country:US
Practice Address - Phone:406-677-3617
Practice Address - Fax:406-677-3618
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-09
Last Update Date:2016-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT1276111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty