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Organization
EVOLUTION JOINT PAIN CLINIC
Active
Organization
EVOLUTION JOINT PAIN CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEREMY LAMONT PAYNE ND, DC (MEMBER)
(208) 917-2928
Entity
Organization
Contact information
Practice address
951 E PLAZA DR STE 170, EAGLE, ID 83616-6569
(208) 917-2928
Mailing address
951 E PLAZA DR STE 170, EAGLE, ID 83616-6569
(208) 917-2928
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
—
NULL
163W00000X
Registered Nurse
—
—
175F00000X
Naturopath
Primary
—
NULL
175F00000X
Naturopath
Primary
—
—
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
—
208VP0000X
Pain Medicine Physician
—
NULL
208VP0000X
Pain Medicine Physician
—
—
Other
Enumeration date
09/29/2021
Last updated
08/18/2026
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