Organization
WIRICK FAMILY CHIROPRACTIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRADY MATTHEW WIRICK DC (PRESIDENT)
(208) 523-1620
Entity
Organization
Contact information
Practice address
2238 ST. CLAIR, IDAHO FALLS, ID 83404
(208) 523-1620
(208) 523-1497
Mailing address
1542 ELK CREEK DRIVE, IDAHO FALLS, ID 83404
(208) 523-1620
(208) 523-1497
Taxonomy
Speciality
Code
Description
License number
State
111NN0400X
Neurology Chiropractor
Primary
CHIA1203
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1164524658
PROVIDER NPI
ID
Enumeration date
10/23/2006
Last updated
08/22/2020
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