Individual
NICOLAS ASLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
403 S 11TH ST STE 110, BOISE, ID 83702-6968
(208) 343-6900
(208) 343-0642
Mailing address
403 S 11TH ST STE 110, BOISE, ID 83702-6968
(208) 343-6900
(208) 343-0642
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CHIA1890
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CHIA1890
IDAHO STATE LICENSE
ID
Enumeration date
10/23/2018
Last updated
10/23/2018
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