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General NPI Number Information
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NPI Number | 1184865073
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Entity Type | Organization
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Legal Business Name | FOX CHIROPRACTIC CLINIC P.A.
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Dates
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Enumeration Date | 03/23/2009
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Last Update Date | 03/23/2009
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Provider Practice Location Address
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Address Line | 1126 EASTLAND DR N SUITE 300
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City | TWIN FALLS
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State | ID
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Zip | 83301-8941
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Country | US
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Telephone | 208-734-7077
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Fax | 208-734-7101
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Provider Business Mailing Address
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Address Line | 1126 EASTLAND DR N SUITE 300
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City | TWIN FALLS
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State | ID
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Zip | 83301-8941
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Country | US
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Telephone | 208-734-7077
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Fax | 208-734-7101
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Authorized Official
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Title or Position | OWNER
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Name | DR. ALAN FOX
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Credential | D.C.
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Telephone | 208-734-3077
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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-320
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License Number State | ID
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