Provider Demographics
NPI:1679637938
Name:HEALTHY FAMILY CHIROPRACTIC PC
Entity Type:Organization
Organization Name:HEALTHY FAMILY CHIROPRACTIC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESDIENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CARL
Authorized Official - Middle Name:R
Authorized Official - Last Name:GLAETTLI
Authorized Official - Suffix:II
Authorized Official - Credentials:DC
Authorized Official - Phone:208-466-2536
Mailing Address - Street 1:107 14TH AVE SO
Mailing Address - Street 2:
Mailing Address - City:NAMPA
Mailing Address - State:ID
Mailing Address - Zip Code:83651
Mailing Address - Country:US
Mailing Address - Phone:208-466-2536
Mailing Address - Fax:208-466-2657
Practice Address - Street 1:107 14TH AVE SO
Practice Address - Street 2:
Practice Address - City:NAMPA
Practice Address - State:ID
Practice Address - Zip Code:83651
Practice Address - Country:US
Practice Address - Phone:208-466-2536
Practice Address - Fax:208-466-2657
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty