Organization
RESET P.A.
Active
Other names
Bear Lake Family Chiropractic
Organization subpart
No
Provider details
NPI number
Authorized official
MATTHEW BRINTON STEVENS D.C. (PRESIDENT/OWNER)
(208) 847-2273
Entity
Organization
Contact information
Practice address
710 N 4TH ST, MONTPELIER, ID 83254-1050
(208) 847-2273
(208) 847-0678
Mailing address
PO BOX 26, MONTPELIER, ID 83254-0026
(208) 847-2273
(208) 847-0678
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1106
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010155708
REGENCY BLUE SHIELD OF ID
ID
01
—
5638605
FIRST HEALTH
ID
01
—
C4959
BLUE CROSS
ID
01
—
P271311
RR MEDICARE
ID
Enumeration date
08/30/2006
Last updated
08/22/2020
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