| NPI | 1558957209 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AARON RANDALL GARDNER Owner 208-365-2024 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor |
| Additional Taxonomies | 225700000X Massage Therapist |
| Enumeration Date | 2020-12-16 |
| Last Update Date | 2024-12-02 |