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General NPI Number Information
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NPI Number | 1184782963
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Entity Type | Organization
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Legal Business Name | MCCALL CHIROPRACTIC INC.
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Dates
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Enumeration Date | 12/05/2006
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Last Update Date | 02/28/2024
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Provider Practice Location Address
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Address Line | 301 E PARK ST
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City | MCCALL
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State | ID
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Zip | 83638-3803
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Country | US
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Telephone | 86-348-2712
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Fax | 208-634-3526
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Provider Business Mailing Address
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Address Line | PO BOX 931
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City | MCCALL
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State | ID
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Zip | 83638
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Country | US
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Telephone | 208-634-8271
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Fax | 208-634-8271
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Authorized Official
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Title or Position | OWNER
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Name | WILLIAM GUY JEPPE III
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Credential |
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Telephone | 208-634-8271
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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 | CHIA914
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License Number State | ID
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