| NPI | 1689709735 |
|---|---|
| Doing Business As | NORTHSIDE CHIROPRACTIC |
| Entity Type | Organization |
| Authorized Contact | MICK L. TIEGS Doctor Of Chiropractic 208-571-8418 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: ID CHIA-1056) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: WA 3119) |
| Enumeration Date | 2007-02-22 |
| Last Update Date | 2008-02-04 |