Organization
GRISAFFI SPORTS CHIROPRACTIC, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ADDISON J GRISAFFI DC (OWNER / DC)
(208) 775-7123
Entity
Organization
Contact information
Practice address
335 E LEWIS ST STE 10, POCATELLO, ID 83201-6408
(208) 775-7123
(208) 550-3256
Mailing address
335 E LEWIS ST STE 10, POCATELLO, ID 83201-6408
(208) 775-7123
(208) 550-3348
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
—
Other
Enumeration date
01/03/2019
Last updated
04/13/2020
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