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Individual

DR. NATHAN EVANS

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
D.C.

Contact information

Practice address
190 W BURNSIDE AVE, STE. D, CHUBBUCK, ID 83202-2404
(208) 238-0600
Mailing address
190 W BURNSIDE AVE, STE. D, CHUBBUCK, ID 83202-2404
(208) 238-0600

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CHIA-1178
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
C5625
BLUE CROSS
ID
Enumeration date
06/15/2006
Last updated
07/08/2007
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