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General NPI Number Information
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NPI Number | 1134266398
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Entity Type | Organization
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Legal Business Name | NIELSON FAMILY CHIROPRACTIC INC
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Dates
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Enumeration Date | 01/30/2007
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Last Update Date | 02/03/2011
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Provider Practice Location Address
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Address Line | 260 FALLS AVE STE B
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City | TWIN FALLS
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State | ID
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Zip | 83301-3370
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Country | US
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Telephone | 208-733-2322
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Fax |
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Provider Business Mailing Address
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Address Line | 260 FALLS AVE STE B
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City | TWIN FALLS
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State | ID
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Zip | 83301-3370
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Country | US
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Telephone | 208-733-2322
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | CHAD JAY NIELSON
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Credential | D.C.
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Telephone | 208-733-2322
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | CHIA-1068
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License Number State | ID
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