Organization
GREENWAY CORPORATION
Active
Other names
Pend Oreille Chiropractic
Organization subpart
No
Provider details
NPI number
Authorized official
KELLY GREENWAY (OFFICE MANAGER)
(208) 255-1108
Entity
Organization
Contact information
Practice address
229 PINE ST, SANDPOINT, ID 83864-1336
(208) 255-1108
(208) 265-5696
Mailing address
229 PINE ST, SANDPOINT, ID 83864-1336
(208) 255-1108
(208) 265-5696
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CHIA-1062
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1377457
MEDICARE PTAN
ID
Enumeration date
11/06/2007
Last updated
11/06/2007
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