Organization
ELEMENTAL WELLNESS & CHIROPRACTIC
Active
Other names
EWC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JUSTIN JAMES PETERSEN DC (PRESIDENT)
(208) 337-8412
Entity
Organization
Contact information
Practice address
343 E MAIN ST, WEISER, ID 83672-2515
(208) 414-3333
Mailing address
343 E MAIN ST, WEISER, ID 83672-2515
(208) 414-3333
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CHIA-1344
ID
Other
Enumeration date
01/11/2012
Last updated
01/11/2012
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