Provider Demographics
NPI:1447311907
Name:SPINE AND SPORTS CHIROPRACTIC CLINIC OF BELGRADE
Entity type:Organization
Organization Name:SPINE AND SPORTS CHIROPRACTIC CLINIC OF BELGRADE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KATY
Authorized Official - Middle Name:A
Authorized Official - Last Name:SATCHELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:406-388-1446
Mailing Address - Street 1:321 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BELGRADE
Mailing Address - State:MT
Mailing Address - Zip Code:59714-3410
Mailing Address - Country:US
Mailing Address - Phone:406-388-1446
Mailing Address - Fax:406-388-9607
Practice Address - Street 1:321 W MAIN ST
Practice Address - Street 2:
Practice Address - City:BELGRADE
Practice Address - State:MT
Practice Address - Zip Code:59714-3410
Practice Address - Country:US
Practice Address - Phone:406-388-1446
Practice Address - Fax:406-388-9607
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-12
Last Update Date:2012-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT000084028Medicare PIN
U25826Medicare UPIN