Individual
MR. TY OGATA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
12353 W MCMILLAN RD, BOISE, ID 83713-5052
(208) 938-3334
(208) 938-3335
Mailing address
12353 W MCMILLAN RD, BOISE, ID 83713-5052
(208) 938-3334
(208) 938-3335
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CHIA920
ID
Other
Enumeration date
12/18/2006
Last updated
12/11/2012
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