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Individual

STANFORD MARK STEKETEE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.C.

Contact information

Practice address
104 SOUTH MAIN STREET, BOULDER, MT 59632-0566
(406) 225-3111
(406) 225-3444
Mailing address
PO BOX 566, 104 SOUTH MAIN STREET, BOULDER, MT 59632-0566
(406) 225-3111
(406) 225-3444

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1008
MT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0000040723
BLUE CROSS BLUE SHIELD
MT
05
0000164322
MT
01
81039
EBMS
MT
Enumeration date
01/05/2007
Last updated
07/08/2007
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