Individual
MR. JEREMY HENRY RAUSCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
1390 S MAPLE GROVE RD, BOISE, ID 83709-1610
(208) 672-0100
(208) 672-0200
Mailing address
1390 S MAPLE GROVE RD, BOISE, ID 83709-1610
(208) 672-0100
(208) 672-0200
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CHIA- 1169
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
807410300
—
ID
Enumeration date
11/22/2006
Last updated
01/10/2013
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