Organization
IDAHO SPINE CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RONALD EUGENE PERRY DC (DOCTOR OF CHIROPRACTIC)
(208) 766-8111
Entity
Organization
Contact information
Practice address
148 E 50 S, MALAD CITY, ID 83252-1368
(208) 766-8111
(208) 766-8111
Mailing address
PO BOX 69, MALAD CITY, ID 83252-0069
(208) 766-8111
(208) 766-8111
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CHIA-837
ID
Other
Enumeration date
02/03/2010
Last updated
02/03/2010
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