| NPI | 1114191137 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICOLE WILLIS Chiropractor, Owner 208-322-4114 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: ID CHIA-1268, CHIA-1267) |
| Enumeration Date | 2008-04-22 |
| Last Update Date | 2008-10-06 |