Individual
DR. DARYL A MOSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
2110 E 25TH ST, IDAHO FALLS, ID 83404-6475
(208) 524-3018
(208) 524-3019
Mailing address
2110 E 25TH ST, IDAHO FALLS, ID 83404-6475
(208) 524-3018
(208) 524-3019
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CHIA 896
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010028117
BLUE SHIELD #
ID
05
—
807164600
—
ID
01
—
C1823
BLUE CROSS NUMBER
ID
Enumeration date
12/18/2006
Last updated
02/21/2017
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