Organization
CHIROPRACTIC CLINIC OF THREE FORKS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DONALD C FUNKE DC (OWNER)
(406) 285-6935
Entity
Organization
Contact information
Practice address
217 MAIN ST, THREE FORKS, MT 59752-1307
(406) 285-6935
(406) 285-6935
Mailing address
PO BOX 1307, 217 MAIN ST, THREE FORKS, MT 59752-1307
(406) 285-6935
(406) 285-6935
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
583
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000042163
BLUE CROSS BLUE SHIELD
MT
Enumeration date
02/24/2009
Last updated
02/24/2009
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