Organization
MICHAEL RAE CHIROPRACTIC PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL DENNIS RAE D.C. (DOCTOR OF CHIROPRACTIC/ OWNER)
(208) 345-3630
Entity
Organization
Contact information
Practice address
1149 W BOISE AVE, BOISE, ID 83706-3503
(208) 345-3630
(208) 345-3640
Mailing address
1149 W BOISE AVE, BOISE, ID 83706-3503
(208) 345-3630
(208) 345-3640
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CHIA1332
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1194057802
INDIVIDUAL NPI
ID
Enumeration date
05/17/2013
Last updated
05/17/2013
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