<Unavail>

LBN: Active Living Chiropractic & Wellness Llc
<Unavail> is an health care organization with primary practice located at 13999 W Wainwright Dr Ste 201 , Boise ID 83713-1969. The organization recently has only one registered license in Chiropractic Providers / Chiropractor, which is considered as the primary health care specialty. Active Living Chiropractic & Wellness Llc can be contacted via phone (208) 939-0775, or through Miller, Krysta via phone (208) 939-0775.

Contact Information

Primary practice address
13999 W Wainwright Dr Ste 201 Boise ID 83713-1969
Phone: (208) 939-0775
Fax: (208) 575-6114
Website:
Map and Directions
Authorized official contact:
Name: Miller, Krysta
Phone: (208) 939-0775

Health care specialties

SpecialtyCodeLicense #State
Chiropractic Providers / Chiropractor 111N00000X

Profile Details

NPI number 1316415623
LBN Legal business name Active Living Chiropractic & Wellness Llc
DBA Doing business as <Unavail>
Authorized official Miller, Krysta
Entity Organization
Organization subpart 1 No
Enumeration date Nov 5th, 2018
Last updated Feb 19th, 2019 - about 7 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1316415623 NPPES
Idaho MEDICAID IDTPID012211

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