Organization
ROAM IND LLC
Active
Organization
ROAM IND LLC
Active
Other names
Premiere Spine & Sport
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JUSTIN P BRINK DC (OWNER)
(208) 968-6700
Entity
Organization
Contact information
Practice address
36 N ECHOHAWK LN STE 104B, EAGLE, ID 83616-4013
(208) 968-6700
(208) 563-3938
Mailing address
36 N ECHOHAWK LN STE 104B, EAGLE, ID 83616-4013
(208) 968-6700
(208) 563-3938
Taxonomy
Speciality
Code
Description
License number
State
111NR0400X
Rehabilitation Chiropractor
Primary
—
—
111NS0005X
Sports Physician Chiropractor
—
—
Other
Enumeration date
03/03/2025
Last updated
03/05/2025
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