The Other Road Incorporated

NPI #1700106663 in Meridian, Idaho

Provider Information

NPI Number
1700106663
Entity Type
Organization
Organization Name
The Other Road Incorporated
Primary Specialty
Chiropractor
Enumeration Date
Jun 2, 2010
Last Updated
Jun 2, 2010

Practice Location

Address
1640 W CHERRY LN # 130
State
Idaho
ZIP Code
83642-8187
Phone
(208) 895-8595

Authorized Official

Name
DR. MATTHEW DAVID HALES, D.C.
Title
VICE-PRESIDENT
Phone
(208) 895-8595

Specialties & Taxonomy Codes

Specialty
Chiropractor

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