Organization
CHARLES GREEN CHIROPRACTOR
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES WILLIAM GREEN D.C. (PRESIDENT)
(208) 429-8085
Entity
Organization
Contact information
Practice address
7683 W RIVERSIDE DR, BOISE, ID 83714-6188
(208) 429-8085
Mailing address
7683 W RIVERSIDE DR, BOISE, ID 83714-6188
(208) 429-8085
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
C-534
ID
Other
Enumeration date
03/13/2008
Last updated
03/13/2008
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