Individual
MIKEAL BRUCE NAVE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
108 E 6TH ST, EMMETT, ID 83617-3536
(208) 365-6300
(208) 365-6309
Mailing address
108 E 6TH ST, EMMETT, ID 83617-3536
(208) 365-6300
(208) 365-6309
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CHIA-1417
ID
111N00000X
Chiropractor
DC15672
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DC0156720
BLUE SHIELD BLUE CORSS
CA
Enumeration date
02/26/2007
Last updated
05/26/2011
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