Bitterroot Valley Spinal Care PLLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

BITTERROOT VALLEY SPINAL CARE PLLC

Practice address

289 Rodeo Dr
Suite 3
Florence, MT 59833-6826

Phone

(636) 399-2588

NPI assigned

Jul 7, 2010

Last updated

Aug 25, 2010By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Shawn D Wanderaas, DC

Title

Owner

Phone

(636) 399-2588

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1278460800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1282694400000",
    "number": "1669784666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "289 RODEO DR",
            "address_2": "SUITE 3",
            "city": "FLORENCE",
            "state": "MT",
            "postal_code": "598336826",
            "telephone_number": "636-399-2588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "289 RODEO DR",
            "address_2": "SUITE 3",
            "city": "FLORENCE",
            "state": "MT",
            "postal_code": "598336826",
            "telephone_number": "636-399-2588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BITTERROOT VALLEY SPINAL CARE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-07",
        "last_updated": "2010-08-25",
        "status": "A",
        "authorized_official_last_name": "WANDERAAS",
        "authorized_official_first_name": "SHAWN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "636-399-2588",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Chiropractor in Florence, MT
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2010; 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.