Individual
DR. JON MCKAY HARMON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
9161 W BLACK EAGLE DR, BOISE, ID 83709-1572
(208) 321-1500
(208) 321-8687
Mailing address
9161 W BLACK EAGLE DR, BOISE, ID 83709-1572
(208) 321-1500
(208) 321-8687
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CHIA590
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010145823
BLUE SHIELD OF IDAHO
ID
01
—
C9388
BLUE CROSS OF IDAHO
ID
01
—
CHIA590
LICENSE #
ID
Enumeration date
09/01/2005
Last updated
07/08/2007
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