Individual
STANLEY A GILLETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
107 14TH AVE S, NAMPA, ID 83651
(208) 466-2536
Mailing address
212 5TH AVE S, NAMPA, ID 83651-3740
(208) 312-0559
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CHIA-1572
ID
Other
Enumeration date
11/04/2013
Last updated
05/17/2018
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