Individual
CHRISTOPHER ALLEN STOCKWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
679 N FIVE MILE RD, BOISE, ID 83713-8025
(208) 863-0447
Mailing address
5027 CREE WAY, BOISE, ID 83709-5344
(208) 863-0447
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CHIA-746
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8N130
CLINIC NUMBER
ID
01
—
C5697
BLUE CROSS NUMBER
ID
01
—
CHIA-746
CHIROPRACTIC LICENSE NUMBER
ID
Enumeration date
01/26/2009
Last updated
02/02/2009
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