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General NPI Number Information
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NPI Number | 1982147443
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Entity Type | Organization
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Legal Business Name | PICKMAN CHIROPRACTIC
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Dates
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Enumeration Date | 11/30/2016
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Last Update Date | 11/30/2016
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Provider Practice Location Address
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Address Line | 3085 E MAGIC VIEW DR STE 180
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City | MERIDIAN
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State | ID
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Zip | 83642-3757
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Country | US
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Telephone | 208-888-6077
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Fax | 888-447-1415
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Provider Business Mailing Address
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Address Line | 3085 E MAGIC VIEW DR STE 180
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City | MERIDIAN
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State | ID
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Zip | 83642-3757
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Country | US
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Telephone | 208-888-6077
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Fax | 888-447-1415
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MS. BRITTANY GLENN MCQUILKIN
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Credential |
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Telephone | 208-888-6077
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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-1742
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License Number State | ID
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