Organization
O'NEILL CLINIC, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THOMAS DANIEL O'NEILL D.C. (PRESIDENT)
(208) 664-5000
Entity
Organization
Contact information
Practice address
1617 LINCOLN WAY, COEUR D ALENE, ID 83814-2422
(208) 664-5000
(208) 667-8098
Mailing address
1617 LINCOLN WAY, COEUR D ALENE, ID 83814-2422
(208) 664-5000
(208) 667-8098
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
CHIA469
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
31546
REGENCE BLUE SHIELD
ID
01
—
C4694
BLUE CROSS
ID
Enumeration date
05/19/2008
Last updated
09/18/2008
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