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Individual

DR. DANIEL R. PRIDEAUX

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.C.

Contact information

Practice address
1001 SW HIGGINS AVE, SUITE 102, MISSOULA, MT 59803-1341
(406) 721-4425
(406) 721-4426
Mailing address
1001 SW HIGGINS AVE, SUITE 102, MISSOULA, MT 59803-1341
(406) 721-4425
(406) 721-4426

Taxonomy

Speciality
Code
Description
License number
State
111NS0005X
Sports Physician Chiropractor
Primary
437
MT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
4142-0
BC/BS
MT
Enumeration date
09/14/2006
Last updated
07/08/2007
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