Provider Demographics
NPI:1669151213
Name:ROBERTS, ELIZABETH LEE (DC)
Entity type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:LEE
Last Name:ROBERTS
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 1:803 N 2ND ST
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:MT
Mailing Address - Zip Code:59840-2111
Mailing Address - Country:US
Mailing Address - Phone:406-363-2111
Mailing Address - Fax:406-363-0836
Practice Address - Street 1:803 N 2ND ST
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:MT
Practice Address - Zip Code:59840-2111
Practice Address - Country:US
Practice Address - Phone:406-363-2111
Practice Address - Fax:406-363-0836
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-12
Last Update Date:2024-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT8168111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty