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Individual

CORY SHANE LINDSTROM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.C.

Contact information

Practice address
5216 E. CLEVELAND BLVD, STE G, CALDWELL, ID 83607
(208) 454-5500
(208) 454-8877
Mailing address
5216 E. CLEVELAND BLVD., STE G, CALDWELL, ID 83607
(208) 454-5500
(208) 454-8877

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CHIA-1335
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
808502300
ID
Enumeration date
12/16/2008
Last updated
04/06/2010
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