Organization
HEALTH SPARK, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RUSSELL ALLEN DC (OWNER)
(208) 994-4747
Entity
Organization
Contact information
Practice address
4771 N SUMMIT WAY STE 110, MERIDIAN, ID 83646-5017
(208) 994-4747
Mailing address
4771 N SUMMIT WAY STE 110, MERIDIAN, ID 83646-5017
(208) 994-4747
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
—
Other
Enumeration date
10/18/2023
Last updated
10/23/2023
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