| NPI | 1568778298 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANN THOMAS Administrative Assistant 208-664-5225 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: ID CHIA-1391) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: ID CHIA-1389) |
| Enumeration Date | 2010-08-18 |
| Last Update Date | 2010-09-17 |