NPI 1902155146 · live from the CMS NPI Registry
Healthsource Of Gillette INC.
Chiropractor in Gillette, WY. National Provider Identifier 1902155146, active.
NPI record
| NPI | 1902155146 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Chiropractor 111N00000X |
| Practice location | 110 E Lakeway Rd, Ste 1000, Gillette, WY 82718 |
| Practice phone | 307-670-9426 |
| Enumerated | September 4, 2012 |
| Last updated | August 17, 2015 |
| Authorized official | Matthew Arnio, Owner |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Chiropractor, Rehabilitation | 111NR0400X | 703 (WY) |
| Chiropractor, Orthopedic | 111NX0800X | 703 (WY) |
| Chiropractor primary | 111N00000X | 703 (WY) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.