Individual
CODY WILHELM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
1505 MADRONA ST N # 900C, TWIN FALLS, ID 83301-8318
(208) 203-3155
Mailing address
29 CANYON VIEW RD, JEROME, ID 83338-6012
(208) 203-3155
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CHIA-2005
ID
Other
Enumeration date
05/13/2020
Last updated
06/04/2020
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