Chiropractic Clinic of Three Forks

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

583 Issued in MT

Legal business name

CHIROPRACTIC CLINIC OF THREE FORKS

Practice address

217 Main St
Three Forks, MT 59752-1307

Phone

(406) 285-6935

Fax

(406) 285-6935

NPI assigned

Feb 24, 2009

Organization subpart

No

Name

Dr. Donald C Funke, DC

Title

Owner

Phone

(406) 285-6935

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Feb 24, 2009.

{
    "created_epoch": "1235433600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1235433600000",
    "number": "1104066646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1307",
            "address_2": "217 MAIN ST",
            "city": "THREE FORKS",
            "state": "MT",
            "postal_code": "597521307",
            "telephone_number": "406-285-6935",
            "fax_number": "406-285-6935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "217 MAIN ST",
            "city": "THREE FORKS",
            "state": "MT",
            "postal_code": "597521307",
            "telephone_number": "406-285-6935",
            "fax_number": "406-285-6935"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHIROPRACTIC CLINIC OF THREE FORKS",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-02-24",
        "last_updated": "2009-02-24",
        "status": "A",
        "authorized_official_last_name": "FUNKE",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "406-285-6935",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MT",
            "license": "583",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "0000042163",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• All providers in Three Forks, MT
• Chiropractor in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.