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Organization

EVOLUTION CHIROPRACTIC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. THOMAS R BENCH D.C (OWNER)
(208) 552-9600
Entity
Organization

Contact information

Practice address
1410 E 17TH ST, IDAHO FALLS, ID 83404-6269
(208) 552-9600
Mailing address
1410 E 17TH ST, IDAHO FALLS, ID 83404-6269
(208) 552-9600

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CHIA-1393
ID

Other

Enumeration date
10/27/2015
Last updated
10/27/2015
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