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Convergence Chiropractic Company

Chiropractor in Boise, ID. Organization (NPI-2).

NPI number1962027433
StatusActive
Last updated in NPPESJun 10, 2020

Details

NPI
1962027433
Entity type
Organization (NPI-2)
Legal business name
Convergence Chiropractic Company
Organization subpart
No
Enumeration date
Jun 10, 2020
Certification date
Jun 10, 2020
Last updated
Jun 10, 2020

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
111N00000X Chiropractor––Yes

Other names

  • Revolution Chiropractic (Doing Business As)

Practice location

404 E Parkcenter Blvd Ste 170
Boise, ID 83706-7564

Phone 505-504-2174

Mailing address

404 E Parkcenter Blvd Ste 170
Boise, ID 83706-7564

Phone 505-504-2174

Authorized official

James Brant Barker
Chiropractic Physician
5055042174

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