THE OTHER ROAD INCORPORATED NPI 1700106663

NPI Information

THE OTHER ROAD INCORPORATED is a chiropractor in Meridian, ID. The provider is a provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. THE OTHER ROAD INCORPORATED NPI is 1700106663. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Evergreen Chiropractic.

The provider's business location address is:

1640 W CHERRY LN # 130
MERIDIAN, ID
ZIP 83642-187
Phone: (208) 895-8595
Fax: (208) 895-8594

The provider's authorized official is Matthew David Hales .
The authorized official title is Vice-president and has the following contact phone number (208) 895-8595.

The enumeration date for this NPI number is 6/2/2010 and was last updated on 6/2/2010.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

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