Charles Wettach, DC
Individual provider Active NPI Chiropractor · Kalispell, MT
NPI 1154475606 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1154475606
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- C 367 (MT)
- Practice address
- 22 2ND Ave W
Suite 1000
Kalispell, MT 59901 - Phone
- (406) 257-0550
- Fax
- (406) 257-0550
- NPI assigned
- Jan 22, 2007
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C 367 | MT | MD | Chiropractor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | C 367 | MT | Yes |
Addresses
Primary practice location
22 2ND Ave W
Suite 1000
Kalispell, MT 59901
Mailing address
22 2ND Ave W
Suite 1000
Kalispell, MT 59901
Phone (406) 257-0550
Other providers in Kalispell, MT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.