Individual
MICHAEL WIDMANN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
1674 W HILL RD, SUITE #4, BOISE, ID 83702-0958
(208) 918-1015
Mailing address
1674 W HILL RD, SUITE #4, BOISE, ID 83702-0958
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CHIA-1586
ID
Other
Enumeration date
10/21/2014
Last updated
10/21/2014
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