Healthcare Provider Details

I. General information

NPI: 1366098774
Provider Name (Legal Business Name): UNLIMITED HEALTH CHIROPRACTIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/12/2019
Last Update Date: 08/12/2024
Certification Date: 08/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

611 E SHERMAN AVE
COEUR D ALENE ID
83814-2732
US

IV. Provider business mailing address

320 E NEIDER AVE STE 103
COEUR D ALENE ID
83815-6007
US

V. Phone/Fax

Practice location:
  • Phone: 208-930-0045
  • Fax: 888-443-4939
Mailing address:
  • Phone: 208-930-4944
  • Fax: 888-443-4939

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: BRIAN JEFFREY HULL
Title or Position: OWNER OF GROUP
Credential: DC
Phone: 208-930-4944