Provider Demographics
NPI:1720317704
Name:RISING, DUSTIN ROBERT (DC)
Entity type:Individual
Prefix:DR
First Name:DUSTIN
Middle Name:ROBERT
Last Name:RISING
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:626 S FERGUSON AVE
Mailing Address - Street 2:STE 5
Mailing Address - City:BOZEMAN
Mailing Address - State:MT
Mailing Address - Zip Code:59718-6409
Mailing Address - Country:US
Mailing Address - Phone:406-551-2177
Mailing Address - Fax:406-551-2177
Practice Address - Street 1:626 S FERGUSON AVE
Practice Address - Street 2:SUITE 4
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59718-6408
Practice Address - Country:US
Practice Address - Phone:406-551-2177
Practice Address - Fax:406-551-2179
Is Sole Proprietor?:No
Enumeration Date:2009-12-21
Last Update Date:2017-03-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MT1218111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor