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General NPI Number Information
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NPI Number | 1780074856
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Entity Type | Organization
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Legal Business Name | OBERTI CHIROPRACTIC INC
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Dates
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Enumeration Date | 01/28/2015
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Last Update Date | 01/28/2015
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Provider Practice Location Address
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Address Line | 430 W IOWA AVE STE A
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City | NAMPA
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State | ID
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Zip | 83686-2826
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Country | US
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Telephone | 916-580-8352
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Fax |
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Provider Business Mailing Address
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Address Line | 430 W IOWA AVE STE A
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City | NAMPA
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State | ID
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Zip | 83686-2826
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Country | US
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Telephone | 916-580-8352
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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. ANTHONY JOSEPH OBERTI
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Credential | D.C.
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Telephone | 916-580-8352
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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-1644
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License Number State | ID
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