Organization
ELLIS CHIROPRACTIC INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VALDEN J ELLIS D.O. (OWNER)
(208) 782-9793
Entity
Organization
Contact information
Practice address
745 W BRIDGE ST STE F, BLACKFOOT, ID 83221-2000
(208) 782-9793
(208) 782-1999
Mailing address
745 W. BRIDGE ST. SUITE F, BLACKFOOT, ID 83221
(208) 782-9793
(208) 782-1999
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
860
ID
Other
Enumeration date
09/17/2007
Last updated
09/17/2007
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