Organization Name: | WEST CHIROPRACTIC CLINIC PA |
NPI Number: | 1124157664 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JASON D WEST (OWNER) |
Mailing Address: | 1188 Call Place Pocatello |
State: | ID US |
Postal Code: | 83201 |
Phone Number: | 2082323216 |
Fax Number: | 2082329412 |
NPI Enumeration Date: | 03/02/2007 |
NPI Last Update Date: | 06/16/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | ID |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |