Individual
KYLE BLEVINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
405 S 8TH ST STE 290, BOISE, ID 83702-7100
(208) 342-7136
Mailing address
405 S 8TH ST STE 290, BOISE, ID 83702-7100
(208) 342-7136
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CHIA-1560
ID
Other
Enumeration date
09/19/2013
Last updated
09/19/2013
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