| NPI | 1891909636 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN J RAE Doctor, Owner 208-345-3630 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: ID CHIA1046) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: ID 895294) |
| Enumeration Date | 2007-05-10 |
| Last Update Date | 2008-02-28 |