Organization
ELITE SPINAL PERFORMANCE CHIROPRACTIC PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DEREK C CALAWAY DC (OWNER)
(208) 557-9616
Entity
Organization
Contact information
Practice address
661 S WOODRUFF AVE, IDAHO FALLS, ID 83401-5596
(208) 557-9616
(208) 534-5816
Mailing address
661 S WOODRUFF AVE, IDAHO FALLS, ID 83401-5596
(208) 557-9616
(208) 534-5816
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
—
Other
Enumeration date
09/08/2020
Last updated
09/08/2020
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