| NPI | 1316415623 |
|---|---|
| Doing Business As | ACTIVE LIVING CHIROPRACTIC AND WELLNESS |
| Entity Type | Organization |
| Authorized Contact | KRYSTA MILLER Billing Specialist 208-939-0775 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor |
| Enumeration Date | 2018-11-05 |
| Last Update Date | 2019-02-19 |