Organization
CHIROPRACTIC SPINE CARE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICAH L RANDALL DC (OWNER)
(208) 323-8600
Entity
Organization
Contact information
Practice address
10108 W OVERLAND RD, STE. B, BOISE, ID 83709-1428
(208) 323-8600
(208) 323-8603
Mailing address
10108 W OVERLAND RD STE B, BOISE, ID 83709-1428
(208) 323-8600
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CHIA1015
ID
Other
Enumeration date
12/27/2006
Last updated
10/15/2008
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