| NPI | 1407354574 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACOB BOWER Chiropractor 208-466-0200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: ID CHIA-1618) |
| Additional Taxonomies | 225100000X Physical Therapist |
| Enumeration Date | 2018-01-24 |
| Last Update Date | 2021-05-25 |