Provider Demographics
NPI:1457761520
Name:DR.UMA'S HEALING AND CREATIVE ARTS CENTER INC.
Entity Type:Organization
Organization Name:DR.UMA'S HEALING AND CREATIVE ARTS CENTER INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:LINDA UMA
Authorized Official - Middle Name:JOY
Authorized Official - Last Name:MULNICK
Authorized Official - Suffix:
Authorized Official - Credentials:DC, DABCI, FIAMA
Authorized Official - Phone:208-343-5532
Mailing Address - Street 1:4105 W STATE ST
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83703-4438
Mailing Address - Country:US
Mailing Address - Phone:208-343-5532
Mailing Address - Fax:208-343-6035
Practice Address - Street 1:4105 W STATE ST
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83703-4438
Practice Address - Country:US
Practice Address - Phone:208-343-5532
Practice Address - Fax:208-343-6035
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-29
Last Update Date:2014-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDACC-67111N00000X
IDCHIA-595111NI0900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NI0900XChiropractic ProvidersChiropractorInternistGroup - Single Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty