| NPI | 1891880779 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES CRIDDLE GARDNER Owner/Manager 208-529-1919 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: ID CHIA 904) |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2020-08-22 |