NPI age
19 years
Enumerated 2007-02-05
Across 1165 active chiropractor providers in Idaho.
| Type | Value | Notes |
|---|---|---|
| 01 (ID) | 1377457 | PTAN |
| 01 (ID) | C4066 | BILING # BLUE CROSS |
Part of a multi-provider practice. 1 other active provider shares this practice address in NPPES.
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