Healthcare Provider Details

I. General information

NPI: 1942820824
Provider Name (Legal Business Name): MOTION CHIROPRACTIC PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/21/2020
Last Update Date: 04/21/2020
Certification Date: 04/21/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1390 S MAPLE GROVE RD STE 200
BOISE ID
83709-1610
US

IV. Provider business mailing address

1390 S MAPLE GROVE RD STE 200
BOISE ID
83709-1610
US

V. Phone/Fax

Practice location:
  • Phone: 208-672-0100
  • Fax: 208-672-0200
Mailing address:
  • Phone: 208-672-0100
  • Fax: 208-672-0200

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License Number
License Number State

VIII. Authorized Official

Name: MIGUEL SALGADO-GONZALES
Title or Position: CEO/OWNER
Credential: DC
Phone: 541-727-2459