Individual
DR. LANCE SHANE INGWERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C
Contact information
Practice address
104 S DAISY ST, SUITE A, SALMON, ID 83467-4333
(208) 756-5000
Mailing address
104 S DAISY ST, SUITE A, SALMON, ID 83467-4333
(208) 756-5000
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CHIA-1181
ID
Other
Enumeration date
07/05/2006
Last updated
07/08/2007
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