Organization
FULL LIFE CHIROPRACTIC, PA
Active
Other names
Main Health Solutions
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JONATHAN ERIC MAIN DC (OWNER / PRESIDENT)
(208) 895-0858
Entity
Organization
Contact information
Practice address
2300 W EVEREST LN, SUITE #175, MERIDIAN, ID 83646-5925
(208) 895-0858
(208) 895-0561
Mailing address
2300 W EVEREST LN, SUITE #175, MERIDIAN, ID 83646-5925
(208) 895-0858
(208) 895-0561
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
C9495
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C9722
BCBS
ID
Enumeration date
08/13/2007
Last updated
12/20/2010
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