Organization
R LAQUA PC
Active
Other names
Yellowstone Chiropractic Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RYAN PHILLIP LAQUA DC (PRESIDENT)
(406) 433-4757
Entity
Organization
Contact information
Practice address
222 2ND AVE SW, SIDNEY, MT 59270-4020
(406) 433-4757
(406) 433-1131
Mailing address
222 2ND AVE SW, SIDNEY, MT 59270-4020
(406) 433-4757
(406) 433-1131
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
986
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
40363
BCBS PROVIDER NUMBER
MT
Enumeration date
01/12/2012
Last updated
01/12/2012
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