Organization
N.E.X.T. LEVEL HEALTH CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JUSTIN TYRELL HAMMON D.C. (PRESIDENT)
(208) 528-6010
Entity
Organization
Contact information
Practice address
2105 NIAGARA, IDAHO FALLS, ID 83404
(208) 528-6010
(208) 528-6011
Mailing address
2105 NIAGARA ST., IDAHO FALLS, ID 83404
(208) 528-6010
(208) 528-6011
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
ACT-251
ID
261QH0100X
Health Service Clinic/Center
Primary
CHIA-1341
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
808261500
—
ID
Enumeration date
10/11/2011
Last updated
12/09/2016
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