Teton Headwaters, INC DBA Aspen Wellness

NPI #1710101381 in Victor, Idaho

Provider Information

NPI Number: 1710101381
Entity Type: Organization
Organization Name: Teton Headwaters, INC DBA Aspen Wellness
Primary Specialty: Chiropractor
Enumeration Date: Apr 12, 2007
Last Updated: Aug 22, 2020

Practice Location

Address: 164 NORTH MAIN STREET
City: Victor
State: Idaho
ZIP Code: 83455
Phone: (208) 787-1199

Authorized Official

Name: DR. JAMES K DAVIS, DC
Title: OWNER
Phone: (208) 787-1199

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Chiropractor	111N00000X	Primary

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