Organization
RONAN CHIROPRACTIC INC
Active
Other names
Ronan Chiropractic
Organization subpart
No
Provider details
NPI number
Authorized official
ELLEN LUCILLE WICKLUND DC (PRESIDENT)
(406) 676-0170
Entity
Organization
Contact information
Practice address
206 MAIN ST SW, RONAN, MT 59864
(406) 676-0170
(406) 676-0160
Mailing address
206 MAIN ST SW, RONAN, MT 59864
(406) 676-0170
(406) 676-0160
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1050
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0165126
—
MT
01
—
40743
BCBS
MT
01
—
DA6765
RR MEDICARE GROUP
—
01
—
P00067474
RR MEDICARE
MT
Enumeration date
09/11/2006
Last updated
08/22/2020
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