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Contact Information

EAGLE SPORT & FAMILY CHIROPRACTIC PLLC
547 S FITNESS PL
SUITE 110
EAGLE, ID83616-6552
 Phone: 208-939-3986
 Fax: 208-319-2700
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Sports Physician

111NS0005X 35 Chiropractic
Indicates primary specialty

NPI Profile & details for EAGLE SPORT & FAMILY CHIROPRACTIC PLLC

NPI # 1861574410
LBN Legal business name EAGLE SPORT & FAMILY CHIROPRACTIC PLLC
Authorized official KRAIG KNOTTS - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 10/20/2006
Last updated 04/03/2013 - About 13 years ago
Identifiers
ID License # CHIA-1073
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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