Individual
DR. MARIA TERESA GOMEZ SIRUCEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.C.
Contact information
Practice address
3080 E GENTRY WAY, SUITE 110, MERIDIAN, ID 83642-3544
(208) 345-7262
(208) 343-1953
Mailing address
3080 E GENTRY WAY, SUITE 110, MERIDIAN, ID 83642-3544
(208) 345-7262
(208) 343-1953
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CHIA-1370
ID
111NN0400X
Neurology Chiropractor
CHIA-1370
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1093975302
—
ID
Enumeration date
07/08/2009
Last updated
01/10/2013
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