Provider Demographics
NPI:1831367374
Name:KRIEG CHIROPRACTIC CENTER, INC
Entity type:Organization
Organization Name:KRIEG CHIROPRACTIC CENTER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:B
Authorized Official - Last Name:KRIEG
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:406-541-8888
Mailing Address - Street 1:1070 N RUSSELL ST
Mailing Address - Street 2:
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59808-2004
Mailing Address - Country:US
Mailing Address - Phone:406-541-8888
Mailing Address - Fax:406-541-8891
Practice Address - Street 1:1070 N RUSSELL ST
Practice Address - Street 2:
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59808-2004
Practice Address - Country:US
Practice Address - Phone:406-541-8888
Practice Address - Fax:406-541-8891
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-19
Last Update Date:2008-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT950111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MTX94723Medicare UPIN