Individual
DR. BRANDON LISLE TRUJILLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
950 E RIVERSIDE DR, EAGLE, ID 83616-6020
(208) 939-2502
Mailing address
950 E RIVERSIDE DR, EAGLE, ID 83616-6020
(208) 939-2502
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
6760623-1202
UT
111N00000X
Chiropractor
CHIA1581
ID
Other
Enumeration date
10/22/2007
Last updated
02/11/2014
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