Organization · Type 2 NPI
Teton Headwaters, Inc dba Aspen Wellness
Chiropractor · Victor, ID
NPI number
1710101381
Active
Practice location
164 North Main Street
Victor, ID 83455
Fax (208) 787-1199
Mailing address
PO Box 224, 164 N Main Street
Victor, ID 83455-0224
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Chiropractor Primary | 111N00000X | CHIA-462 (ID) |
Chiropractor: A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems.
Another provider at this address
About NPI 1710101381
Teton Headwaters, Inc dba Aspen Wellness's National Provider Identifier is 1710101381, issued on Apr 12, 2007. The primary taxonomy on file is Chiropractor (111N00000X), and the practice location is in Victor, ID. The record was last updated on Aug 22, 2020.