Ellis Chiropractic Inc

NPI 1043406705 - Chiropractor - 111N00000X

NPI Details
NPI 1043406705
Enumeration Date 09/17/2007
Last Updated 09/17/2007
Entity Type Healthcare Provider
Active Over 9 years ago
Authorized Information
Name VALDEN J VALDEN
Position OWNER
Phone (208) 782-9793
Fax (208) 782-1999
Practice Location
745 W BRIDGE ST STE F
BLACKFOOT ID, 83221-2000, US
Phone (208) 782-9793
Fax (208) 782-1999
Business Location
745 W. BRIDGE ST. SUITE F
BLACKFOOT ID, 83221, US
Phone (208) 782-9793
Fax (208) 782-1999
Toxanomy
Taxonomy Code 111N00000X
License State Idaho
License Number 860
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According to our database, Ellis Chiropractic Inc NPI is 1043406705, taxonomy code is 111N00000X and license number is 860, license state is located at Idaho. Ellis Chiropractic Inc physically located at 745 W Bridge St Ste F, Blackfoot ID, 83221-2000. NPI Number 1033115704 has the healthcare provider type.

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1043406705 NPI number is provided on an as is basis without warranty of any kind. 1043406705 is maintained by the National Plan & Provider Enumeration System. The contents of Ellis Chiropractic Inc are for informational purposes only.