Provider Demographics
NPI:1437351293
Name:BIG MOUNTAIN CHIROPRACTIC, P.C.
Entity type:Organization
Organization Name:BIG MOUNTAIN CHIROPRACTIC, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KANYON
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:406-862-7655
Mailing Address - Street 1:6446 US HWY 93 SOUTH
Mailing Address - Street 2:
Mailing Address - City:WHITEFISH
Mailing Address - State:MT
Mailing Address - Zip Code:59937-8237
Mailing Address - Country:US
Mailing Address - Phone:406-862-7655
Mailing Address - Fax:406-862-9750
Practice Address - Street 1:140 2ND ST E
Practice Address - Street 2:
Practice Address - City:WHITEFISH
Practice Address - State:MT
Practice Address - Zip Code:59937-2141
Practice Address - Country:US
Practice Address - Phone:406-862-7655
Practice Address - Fax:406-862-9750
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-04
Last Update Date:2021-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT984111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty