MEDICARE: HARPER CHIROPRACTIC CLINIC, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	CHIA1385	ID
2	111N00000X	Chiropractor	CHIA435	ID

General Provider Information

NPI Number	:	1407149966
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HARPER CHIROPRACTIC CLINIC, INC.

Provider Business Mailing Address
First Line	:	PO BOX 1061
Second Line	:
City	:	OROFINO
State	:	ID
Zip	:	83544-1061
Country	:	US
Telephone Number	:	208-476-3158
Fax Number	:	208-476-7818

Provider Business Practice Location Address
First Line	:	10620 HIGHWAY 12
Second Line	:
City	:	OROFINO
State	:	ID
Zip	:	83544-9372
Country	:	US
Telephone Number	:	208-476-3158
Fax Number	:	208-476-7818

Authorized Official
Title or Position	:	OWNER
Name	:	DR. DENNIS LEE HARPER
Credential	:	D.C., N.D.
Telephone Number	:	208-476-3158

Provider Enumeration Date	:	05/17/2011
Last Update Date	:	05/17/2011

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Directions to “HARPER CHIROPRACTIC CLINIC, INC. ” Practice Location

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