NPI age
19 years
Enumerated 2007-02-23
Across 13 active chiropractor providers in Idaho.
| Type | Value | Notes |
|---|---|---|
| 01 (ID) | 000010008956 | REGENCE BLUE SHIELD |
| 01 (ID) | CHIA-465 | LICENSE |
| 01 (ID) | C9172 | BLUE CROSS |
Solo or small practice. No other active providers share this practice address in NPPES. This provider is listed as a sole proprietor.
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