Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 533 | MT |
NPI | 1003908583 |
---|---|
Provider Name | Mr. Steven L Abraham |
First Address | Butte, MT 59701-3415 |
Second Address | Butte, MT 59701-3415 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/09/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
T89327 | (02) | MT |