| NPI | 1225068059 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER VICTORIA COFFEY Co President 208-879-6754 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: ID CHIA-1182) |
| Enumeration Date | 2006-07-04 |
| Last Update Date | 2020-08-22 |