Individual
MR. VALDEN J ELLIS
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
745 W BRIDGE ST, SUITE F, BLACKFOOT, ID 83221-2000
(208) 782-9793
Mailing address
745 W BRIDGE ST, SUITE F, BLACKFOOT, ID 83221-2000
(208) 782-9793
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
860
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C8604
BLUE CROSS
ID
Enumeration date
05/18/2006
Last updated
07/09/2007
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