Organization
EGBERT CHIROPRACTIC PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAUL EGBERT DC (OWNER)
(208) 736-0887
Entity
Organization
Contact information
Practice address
479 POLK ST, SUITE A, TWIN FALLS, ID 83301-4850
(208) 736-0887
Mailing address
PO BOX 1886, TWIN FALLS, ID 83303-1886
(208) 736-0887
(208) 736-0890
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002707300
—
ID
Enumeration date
08/01/2006
Last updated
10/23/2012
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