Organization
BACK IN ACTION CHIROPRACTIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL EARLEY DC (PRESIDENT)
(435) 554-8827
Entity
Organization
Contact information
Practice address
645 N STATE ST, PRESTON, ID 83263-1153
(208) 852-0411
(208) 485-8045
Mailing address
645 N STATE ST, PRESTON, ID 83263-1153
(208) 852-0411
(208) 485-8045
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CHIA-1544
ID
111NS0005X
Sports Physician Chiropractor
CHIA-1544
ID
Other
Enumeration date
01/26/2015
Last updated
04/01/2015
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