Organization
WILLIS FAMILY CHIROPRACTIC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NICOLE WILLIS DC (CHIROPRACTOR, OWNER)
(208) 322-4114
Entity
Organization
Contact information
Practice address
10451 W GARVERDALE CT, SUITE 201, BOISE, ID 83704-5408
(208) 322-4114
(208) 322-4115
Mailing address
10451 W GARVERDALE CT, SUITE 201, BOISE, ID 83704-5408
(208) 322-4114
(208) 322-4115
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CHIA-1268, CHIA-1267
ID
Other
Enumeration date
04/22/2008
Last updated
10/06/2008
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