Organization
BACK 2 LIFE MEDICAL INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JUSTIN GRIFFIN DC (OWNER/PRESIDENT)
(208) 887-6810
Entity
Organization
Contact information
Practice address
2016 S EAGLE RD, MERIDIAN, ID 83642-6707
(208) 887-6810
(208) 887-6797
Mailing address
2016 S EAGLE RD, MERIDIAN, ID 83642-6707
(208) 887-6810
(208) 887-6797
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
CHIA-874
ID
363L00000X
Nurse Practitioner
Primary
NP-1639A
ID
Other
Enumeration date
07/21/2016
Last updated
07/21/2016
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