| NPI | 1417040031 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL MYRTH MORIARTY Owner/President 208-376-3113 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: ID C392) |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2012-01-04 |