Country Chiropractic INC.
Chiropractor in Pocatello, ID. Organization (NPI-2).
NPI number1962529149
StatusActive
Last updated in NPPESAug 22, 2020
Details
- NPI
- 1962529149
- Entity type
- Organization (NPI-2)
- Legal business name
- Country Chiropractic INC.
- Organization subpart
- No
- Enumeration date
- Mar 23, 2007
- Last updated
- Aug 22, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 111N00000X | Chiropractor | chia779 | ID | Yes |
Practice location
178 E Quinn RdPocatello, ID 83201-3502
Phone 208-237-4223 · Fax 208-237-2011
Mailing address
178 E Quinn RdPocatello, ID 83201-3502
Phone 208-237-4223 · Fax 208-237-2011
Authorized official
Cary Krusoff
President
2082374223
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All 30 Chiropractor providers in Pocatello · All 2,770 providers in Pocatello
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