Individual
GARY CHRISTOPHER WIGHT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
203 N HOLMES AVE, IDAHO FALLS, ID 83401-2613
(208) 522-2591
(208) 522-2591
Mailing address
333 S WOODRUFF AVE, IDAHO FALLS, ID 83401-4322
(208) 522-2591
(208) 524-7489
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CHIA-1163
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C5612
BLUE CROSS ID#
ID
Enumeration date
10/26/2006
Last updated
09/27/2021
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