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Organization

YELLOWSTONE CHIROPRACTIC, PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. ROSS B FULLER DC (PRESIDENT)
(307) 548-9338
Entity
Organization

Contact information

Practice address
223 E MAIN ST, LOVELL, WY 82431-2101
(307) 548-9338
(307) 548-9335
Mailing address
223 E MAIN ST, LOVELL, WY 82431-2101
(307) 548-9338
(307) 548-9335

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
615
WY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
313386
BLUE CROSS BLUE SHIELD
WY
Enumeration date
08/12/2006
Last updated
10/04/2007
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