Organization
MIDDLETON CHIROPRACTIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GEORGE C SQUIRE D.C. (PHYSICIAN)
(208) 585-3657
Entity
Organization
Contact information
Practice address
111 E MAIN ST, MIDDLETON, ID 83644-5705
(208) 585-3657
(208) 585-3658
Mailing address
111 E MAIN ST, MIDDLETON, ID 83644-5705
(208) 585-3657
(208) 585-3658
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CHIA 396
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002501400
—
ID
Enumeration date
05/08/2008
Last updated
05/08/2008
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