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General NPI Number Information
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NPI Number | 1386831931
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Entity Type | Organization
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Legal Business Name | TOTAL HEALTH CHIROPRACTIC, P.C.
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Dates
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Enumeration Date | 09/27/2007
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Last Update Date | 09/27/2007
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Provider Practice Location Address
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Address Line | 285 E 4TH N
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City | MOUNTAIN HOME
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State | ID
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Zip | 83647-2716
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Country | US
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Telephone | 208-587-3345
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Fax | 208-587-7473
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Provider Business Mailing Address
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Address Line | 285 E 4TH N
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City | MOUNTAIN HOME
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State | ID
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Zip | 83647-2716
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Country | US
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Telephone | 208-587-3345
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Fax | 208-587-7473
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. CLIFTON C. ANDREWS
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Credential | D.C.
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Telephone | 208-587-3345
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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-988
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License Number State | ID
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