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Individual

JUSTIN MICHAEL ANDERSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DC

Contact information

Practice address
6744 N GLENWOOD ST, BOISE, ID 83714-1926
(712) 899-8984
Mailing address
6744 N GLENWOOD ST, BOISE, ID 83714-1926
(712) 899-8984

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CHIA-1675
ID
111NR0400X
Rehabilitation Chiropractor
CHIA-1675
ID

Other

Enumeration date
04/07/2016
Last updated
02/07/2021
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