| NPI | 1093513566 |
|---|---|
| Doing Business As | PREMIERE SPINE & SPORT |
| Entity Type | Organization |
| Authorized Contact | JUSTIN P BRINK Owner 208-968-6700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111NR0400X Chiropractor, Rehabilitation |
| Additional Taxonomies | 111NS0005X Chiropractor, Sports Physician |
| Enumeration Date | 2025-03-03 |
| Last Update Date | 2025-03-05 |