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MOSCOW CHIROPRACTIC CLINIC

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Company Details

Name: MOSCOW CHIROPRACTIC CLINIC
Jurisdiction: Idaho
Legal type: Assumed Business Name
Status: Active-Current
Date of registration: 10 Sep 2012 (13 years ago)
Entity Number: 479868
Place of Formation: IDAHO
File Number: 0000479868
ZIP code: 83843
County: Latah County
Mailing Address: 200 S ALMON ST STE 102 MOSCOW, ID 83843

National Provider Identifier

NPI Number:
1134253362

Authorized Person:

Name:
JOHN R SANDELL
Role:
OWNER
Phone:

Taxonomy:

Selected Taxonomy:
111N00000X - Chiropractor
Is Primary:
Yes

Contacts:

Fax:
2088826866

Filing

Filing Name Filing Number Filing date
Initial Filing 0000479868 2012-09-10

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Date of last update: 26 Sep 2024

Sources: Idaho Secretary of State