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Individual

DR. ALAN LEO WAITE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DC

Contact information

Practice address
54 W COURT ST, WEISER, ID 83672-1941
(208) 414-3881
(208) 414-3882
Mailing address
54 W COURT ST, WEISER, ID 83672-1941
(208) 414-3881
(208) 414-3882

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CHIA-437
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
C437-1
BLUE CROSS IDAHO
ID
Enumeration date
02/27/2007
Last updated
07/08/2007
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