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General NPI Number Information
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NPI Number | 1598153694
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Entity Type | Organization
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Legal Business Name | NORTHWOODS CHIROPRACTIC INC
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Dates
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Enumeration Date | 12/26/2014
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Last Update Date | 02/26/2015
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Provider Practice Location Address
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Address Line | 77 W PRAIRIE SHOPPING CTR
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City | HAYDEN
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State | ID
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Zip | 83835-9854
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Country | US
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Telephone | 208-762-3560
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Fax |
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Provider Business Mailing Address
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Address Line | 77 W PRAIRIE SHOPPING CTR
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City | HAYDEN
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State | ID
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Zip | 83835-9854
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Country | US
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Telephone | 208-762-3560
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. PAUL BATTAGLIA
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Credential | D.C
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Telephone | 208-762-3560
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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 - 1611
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License Number State | ID
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