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Organization

IDAHO CHIROPRACTIC GROUP, PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JULIE CAREAGA (BILLING MANAGER)
(208) 343-6900
Entity
Organization

Contact information

Practice address
403 S 11TH ST, SUITE #110, BOISE, ID 83702-6968
(208) 343-6900
(208) 343-0642
Mailing address
PO BOX 7442, BOISE, ID 83707-1442

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CHIA-559
ID
111N00000X
Chiropractor
CHIA-802
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000010027629
BLUE SHIELD
ID
01
C1526
BLUE CROSS
ID
Enumeration date
08/31/2006
Last updated
08/22/2020
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