Organization
THE CHIROPRACTOR AT CASTLEBURY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GARY CRAIG ELLISON DC (MEMBER)
(208) 884-8848
Entity
Organization
Contact information
Practice address
3225 W BAVARIA ST STE 101, EAGLE, ID 83616-5547
(208) 884-8848
(208) 884-8802
Mailing address
3225 W BAVARIA ST STE 101, EAGLE, ID 83616-5547
(208) 884-8848
(208) 884-8802
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CHIA-845
ID
Other
Enumeration date
05/23/2018
Last updated
05/23/2018
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