Brovold, Clayton Irwin
Brovold, Clayton Irwin is an sole proprietor health care provider with primary practice located at 49665 Us Highway 93 , Polson MT 59860-2301. He recently has only one registered license in Chiropractic Providers / Chiropractor, which is considered as his primary health care specialty. Brovold, Clayton Irwin can be contacted via phone (406) 883-4234.Contact Information
Primary practice address
49665 Us Highway 93
Polson MT 59860-2301
Phone: (406) 883-4234
Fax: (406) 883-4297
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Chiropractic Providers / Chiropractor | 111N00000X | 392 | Montana |
Profile Details
| NPI number | 1114142411 |
|---|---|
| LBN Legal business name | Brovold, Clayton Irwin |
| Credentials | Doctor of Chiropractic (DC) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Apr 13th, 2007 |
| Last updated | Nov 17th, 2008 - about 16 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1114142411 | NPPES |
| Montana | MEDICAID | 0000166244 | |
| Montana | MEDICAID | 0000166243 |
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