Individual
MR. LANE STANFORD WRIGHT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DC CCEP
Contact information
Practice address
1100 N COLE RD, BOISE, ID 83704-8644
(208) 375-3500
Mailing address
1100 N COLE RD, BOISE, ID 83704-8644
(208) 375-3500
(208) 375-3716
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CHIA596
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
313314
BS
ID
01
—
350046101
RAILROAD MEDICARE
—
01
—
C5964
BC
ID
Enumeration date
04/28/2006
Last updated
02/28/2024
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