NPI age
20 years
Enumerated 2005-08-01
Across 13 active chiropractor providers in Idaho.
| Type | Value | Notes |
|---|---|---|
| 01 (ID) | C3704 | BLUE CROSS PIN |
| 01 (ID) | 000010019263 | BLUE SHIELD PIN |
Solo or small practice. No other active providers share this practice address in NPPES.
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