| NPI | 1679724330 |
|---|---|
| Former Legal Business Name | ACTIVE CHIROPRACTIC |
| Entity Type | Organization |
| Authorized Contact | JASON WATSON President 208-345-3320 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: ID CHIA-1209) |
| Enumeration Date | 2008-09-30 |
| Last Update Date | 2010-02-18 |