| NPI | 1528211034 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENNNIS JEFFREY COCKRUM President 208-665-7158 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: ID CHIA-970) |
| Enumeration Date | 2008-10-28 |
| Last Update Date | 2008-10-28 |