Individual
DR. GERALD D STAKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
976 JOHN ADAMS PKWY, IDAHO FALLS, ID 83401-4049
(208) 522-5546
(208) 522-4777
Mailing address
976 JOHN ADAMS PKWY, IDAHO FALLS, ID 83401-4049
(208) 522-5546
(208) 522-4777
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CHIA-706
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C-706-9
BLUE CROSS INSURANCE
ID
Enumeration date
10/12/2006
Last updated
07/09/2007
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