Provider Demographics
NPI:1366778003
Name:GUIGNARD, PHILIP P (DC)
Entity type:Individual
Prefix:DR
First Name:PHILIP
Middle Name:P
Last Name:GUIGNARD
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:410 W SPRUCE ST
Mailing Address - Street 2:
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59802-4106
Mailing Address - Country:US
Mailing Address - Phone:406-549-0119
Mailing Address - Fax:
Practice Address - Street 1:410 W SPRUCE ST
Practice Address - Street 2:
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59802-4106
Practice Address - Country:US
Practice Address - Phone:406-549-0119
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-31
Last Update Date:2009-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT1216111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor