Individual
DR. THERESA M CRAMER COULTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.C.
Contact information
Practice address
4619 EMERALD ST STE 102, BOISE, ID 83706-2051
(208) 367-1497
Mailing address
4619 EMERALD ST STE 102, BOISE, ID 83706-2051
(208) 367-1497
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CHIA-798
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010020165
REGENCE BLUE SHIELD OF ID
ID
01
—
C3449
IDAHO BLUE CROSS
ID
Enumeration date
12/06/2006
Last updated
07/08/2007
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