Organization
BACK TO HEALTH CHIROPRACTIC CLINIC INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID GEORGE BOOTH D.C. (PRESIDENT)
(208) 359-2264
Entity
Organization
Contact information
Practice address
60 S 2ND W, REXBURG, ID 83440-1819
(208) 359-2264
Mailing address
60 S 2ND W, REXBURG, ID 83440-1819
(208) 359-2264
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CHIA 804
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010019702
BLUE SHIELD
ID
01
—
C8042
BLUE CROSS
ID
Enumeration date
06/14/2007
Last updated
08/22/2020
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