Provider Demographics
NPI:1144303231
Name:ORLEY, RANDY CRAIG (DC)
Entity type:Individual
Prefix:DR
First Name:RANDY
Middle Name:CRAIG
Last Name:ORLEY
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:629 NORTHEAST MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:LEWISTOWN
Mailing Address - State:MT
Mailing Address - Zip Code:59457
Mailing Address - Country:US
Mailing Address - Phone:406-538-4420
Mailing Address - Fax:406-538-4415
Practice Address - Street 1:629 NE MAIN ST
Practice Address - Street 2:
Practice Address - City:LEWISTOWN
Practice Address - State:MT
Practice Address - Zip Code:59457-2082
Practice Address - Country:US
Practice Address - Phone:406-538-4420
Practice Address - Fax:406-538-4415
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-23
Last Update Date:2013-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT735111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT40961OtherBCBS
MT40961OtherBCBS
MT000004345Medicare ID - Type Unspecified