Organization
IDEALSPINE HEALTH CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHIRLENE HARRISON D.C. (OWNER)
(208) 939-2502
Entity
Organization
Contact information
Practice address
950 E RIVERSIDE DR, EAGLE, ID 83616-6020
(208) 939-2502
Mailing address
950 E RIVERSIDE DR, EAGLE, ID 83616-6020
(208) 939-2502
Taxonomy
Speciality
Code
Description
License number
State
111NR0400X
Rehabilitation Chiropractor
Primary
CHIA-1168
ID
Other
Enumeration date
09/18/2012
Last updated
02/21/2013
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