Healthcare Provider Details
I. General information
NPI: 1144076886
Provider Name (Legal Business Name): KEY CHIROPRACTIC AND WELLNESS CENTERS INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/24/2024
Last Update Date: 04/24/2024
Certification Date: 04/24/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
17085 N WYLIE PL
NAMPA ID
83687-4801
US
IV. Provider business mailing address
17085 N WYLIE PL
NAMPA ID
83687-4801
US
V. Phone/Fax
- Phone: 208-965-2128
- Fax:
- Phone: 208-965-2128
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 111NS0005X |
| Taxonomy | Sports Physician Chiropractor |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
STEVEN
KEY
Title or Position: PRESIDENT/OWNER
Credential: DC
Phone: 208-965-2128