| NPI | 1972780260 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MANDY CLEVERLEY Secretary/Office Manager 208-543-2005 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: ID Chia902) |
| Enumeration Date | 2008-01-29 |
| Last Update Date | 2023-12-06 |