Provider Demographics
NPI:1952943490
Name:BRIDGE CHIROPRACTIC, INC.
Entity Type:Organization
Organization Name:BRIDGE CHIROPRACTIC, INC.
Other - Org Name:ENDURANCE CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:BRIDGE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:406-422-4433
Mailing Address - Street 1:1040 PARTRIDGE PL STE 6
Mailing Address - Street 2:
Mailing Address - City:HELENA
Mailing Address - State:MT
Mailing Address - Zip Code:59602-0518
Mailing Address - Country:US
Mailing Address - Phone:406-422-4433
Mailing Address - Fax:
Practice Address - Street 1:1040 PARTRIDGE PL STE 6
Practice Address - Street 2:
Practice Address - City:HELENA
Practice Address - State:MT
Practice Address - Zip Code:59602-0518
Practice Address - Country:US
Practice Address - Phone:406-422-4433
Practice Address - Fax:406-422-4678
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-16
Last Update Date:2021-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty