Organization
DR. MICHAEL D. RAE, DC, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL D RAE DC (OWNER/ CHIROPRACTOR)
(208) 985-3233
Entity
Organization
Contact information
Practice address
1843 S BROADWAY AVE STE 203A, BOISE, ID 83706-3862
(208) 985-3233
Mailing address
1729 S GRANT AVE, BOISE, ID 83706-3529
(208) 985-3233
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CHIA-1332
IDAHO STATE BOARD OF CHIROPRACTIC PHYSICIAN'S
ID
Enumeration date
08/17/2022
Last updated
06/22/2023
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