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General NPI Number Information
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NPI Number | 1487900205
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Entity Type | Organization
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Legal Business Name | QUALITY CHIROPRACTIC CENTER PLLC
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Dates
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Enumeration Date | 07/30/2012
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Last Update Date | 09/18/2013
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Provider Practice Location Address
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Address Line | 619 S WASHINGTON ST STE 101
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City | MOSCOW
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State | ID
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Zip | 83843-3063
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Country | US
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Telephone | 208-883-4300
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Fax | 208-883-4311
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Provider Business Mailing Address
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Address Line | 619 S WASHINGTON ST STE 101
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City | MOSCOW
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State | ID
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Zip | 83843-3063
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Country | US
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Telephone | 208-883-4300
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Fax | 208-883-4311
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Authorized Official
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Title or Position | OWNER/DOCTOR
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Name | DR. JAMES E MCKENZIE
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Credential | D.C.
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Telephone | 208-883-4300
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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 | CHIA1505
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License Number State | ID
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | CHIA1041
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License Number State | ID
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