Individual
DR. MATTHEW BRINTON STEVENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
710 N 4TH ST, MONTPELIER, ID 83254-1050
(208) 847-2273
(208) 847-0678
Mailing address
PO BOX 26, MONTPELIER, ID 83254-0026
(208) 847-2273
(208) 847-0678
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1106
ID
111N00000X
Chiropractor
289810-1202
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010155708
REGENCY BLUE SHIELD
ID
01
—
5638605
FIRST HEALTH
ID
01
—
C4959
BLUE CROSS PROVIDER NUMBE
ID
01
—
P00271311
RR MEDICARE
ID
Enumeration date
08/30/2006
Last updated
07/09/2007
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