NPI age
19 years
Enumerated 2007-01-03
Across 1165 active chiropractor providers in Idaho.
| Type | Value | Notes |
|---|---|---|
| 01 (ID) | C2284 | BLUE CROSS ID |
| 01 (ID) | 000010034427 | BLUE SHIELD ID |
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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