Organization
15TH STREET CHIROPRACTIC PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK W HERTENSTEIN DC (OWNER)
(406) 771-1222
Entity
Organization
Contact information
Practice address
222 15TH ST S, SUITE C, GREAT FALLS, MT 59405-2459
(406) 771-1222
(406) 771-1225
Mailing address
222 15TH ST S, SUITE C, GREAT FALLS, MT 59405-2459
(406) 771-1222
(406) 771-1225
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
537
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0164398
—
MT
01
—
40763
BLUE CROSS/BLUE SHIELD
MT
Enumeration date
04/03/2008
Last updated
04/03/2008
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