| NPI | 1912331810 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KORY L KREUSEL Owner 208-939-1500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: ID CHIA-1378) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: ID D-468) |
| Enumeration Date | 2013-08-27 |
| Last Update Date | 2016-03-31 |