Individual
JOSEPH AZEVEDO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1907 E KNOBCONE DR, MERIDIAN, ID 83642-8115
(208) 608-9400
Mailing address
1907 E KNOBCONE DR, MERIDIAN, ID 83642-8115
(208) 608-9400
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CHIA-2125
ID
Other
Enumeration date
05/04/2021
Last updated
05/04/2021
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