Provider Demographics
NPI:1710453634
Name:ADIO CHIROPRACTIC
Entity Type:Organization
Organization Name:ADIO CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHASE
Authorized Official - Middle Name:D
Authorized Official - Last Name:DUDLEY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:208-409-7302
Mailing Address - Street 1:503 N 27TH ST
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83702-4704
Mailing Address - Country:US
Mailing Address - Phone:208-409-7302
Mailing Address - Fax:
Practice Address - Street 1:503 N 27TH ST
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83702-4704
Practice Address - Country:US
Practice Address - Phone:208-409-7302
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-18
Last Update Date:2018-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty