Individual
DR. JEFFREY THOMAS WELKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.,C.C.S.P.
Contact information
Practice address
301 N 27TH ST, BOISE, ID 83702-4725
(208) 343-2584
Mailing address
301 N 27TH ST, BOISE, ID 83702-4725
(208) 343-2584
Taxonomy
Speciality
Code
Description
License number
State
111NS0005X
Sports Physician Chiropractor
Primary
C-520
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010007866
REGENCE BLUE SHIELD
ID
01
—
C-520-4
BLUE CROSS OF IDAHO
ID
Enumeration date
01/10/2007
Last updated
07/08/2007
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