| NPI | 1467740068 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEVIN ORTON Manager 208-795-5131 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111NS0005X Chiropractor, Sports Physician (Licence: ID chia1421) |
| Enumeration Date | 2011-07-16 |
| Last Update Date | 2011-07-16 |