NPI | 1467897405 |
---|---|
Entity Type | Organization |
Authorized Contact | RYAN BALLARD WEED President 208-266-7000 |
Organization Subpart ? | No |
Primary Taxonomy | 111N00000X Chiropractor |
Additional Taxonomies | 111N00000X Chiropractor (Licence: ID CHIA-868) |
Enumeration Date | 2013-05-03 |
Last Update Date | 2023-06-01 |