Idaho Spine and Sports Chiropractic INC

NPI #1427242734 in Boise, Idaho

Provider Information

NPI Number: 1427242734
Entity Type: Organization
Organization Name: Idaho Spine and Sports Chiropractic INC
Primary Specialty: Chiropractor
Enumeration Date: Aug 29, 2007
Last Updated: Jan 28, 2015

Practice Location

Address: 2399 S ORCHARD ST
Address 2: STE. 204
City: Boise
State: Idaho
ZIP Code: 83705-3793
Phone: (208) 323-2833

Authorized Official

Name: DR. KENDRICK L TWEEDT, D.C.
Title: OWNER
Phone: (208) 323-2833

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Chiropractor	111N00000X	Primary

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