NPI age
14 years
Enumerated 2012-04-13
Across 1165 active chiropractor providers in Idaho.
| Type | Value | Notes |
|---|---|---|
| 05 (ID) | M8063862 | |
| 01 (ID) | 000010159874 | BLUE SHIELD |
| 01 (ID) | C9905 | BLUE CROSS |
Single-site organization. Only one practice location on file.
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