| NPI | 1245243096 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHEN KYLE BURTENSHAW Owner/Chiropractic Physician 208-672-0100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: ID CHIA-1159) |
| Enumeration Date | 2006-08-14 |
| Last Update Date | 2020-08-22 |