Individual
MR. TIMOTHY KLENA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
403 S 11TH ST, SUITE #110, BOISE, ID 83702-6968
(208) 343-6900
(208) 343-0642
Mailing address
PO BOX 7442, BOISE, ID 83707-1442
(208) 343-6900
(208) 343-0642
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CHIA-559
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010019388
BLUE SHIELD
ID
01
—
C1534
BLUE CROSS
ID
Enumeration date
09/02/2006
Last updated
07/08/2007
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