Organization
ABUNDANTHEALTHFAMILYCHIROPRACTICPC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KIMBERLY A MAXWELL D.C. (PRESIDENT/OWNER)
(406) 585-7000
Entity
Organization
Contact information
Practice address
642 COTTONWOOD RD, SUITE 1, BOZEMAN, MT 59718-9203
(406) 585-7000
Mailing address
PO BOX 160502, BIG SKY, MT 59716-0502
(406) 585-7000
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
868
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000004602
MEDICARE PROVIDER NUMBER
MT
01
—
000084011
MEDICARE GROUP NUMBER
MT
01
—
350047684
RAIL ROAD MEDICARE
MT
01
—
41811
BLUE CROSS/BLUE SHIELD
MT
Enumeration date
04/18/2008
Last updated
07/24/2008
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