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General NPI Number Information
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NPI Number | 1457761520
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Entity Type | Organization
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Legal Business Name | DR.UMA'S HEALING AND CREATIVE ARTS CENTER INC.
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Dates
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Enumeration Date | 04/29/2014
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Last Update Date | 04/29/2014
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Provider Practice Location Address
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Address Line | 4105 W STATE ST
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City | BOISE
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State | ID
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Zip | 83703-4438
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Country | US
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Telephone | 208-343-5532
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Fax | 208-343-6035
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Provider Business Mailing Address
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Address Line | 4105 W STATE ST
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City | BOISE
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State | ID
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Zip | 83703-4438
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Country | US
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Telephone | 208-343-5532
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Fax | 208-343-6035
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Authorized Official
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Title or Position | CHIROPRACTOR
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Name | DR. LINDA UMA JOY MULNICK
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Credential | DC, DABCI, FIAMA
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Telephone | 208-343-5532
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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 | ACC-67
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License Number State | ID
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Taxonomy #2
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Taxonomy Code | 111NI0900X
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Taxonomy Name | Internist Chiropractor
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License Number | CHIA-595
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License Number State | ID
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