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Individual

RANDALL P PRIEBE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.C.

Contact information

Practice address
8109 N WAYNE BLVD, HAYDEN, ID 83835-5031
(208) 667-7463
(208) 762-6385
Mailing address
8109 N WAYNE BLVD, HAYDEN, ID 83835-5031
(208) 667-7463
(208) 762-6385

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CHIA-856
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
805124000
ID
Enumeration date
05/24/2006
Last updated
01/18/2013
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