Individual
DR. KEVIN ROBERT MARSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
8235 N CORNERSTONE DR, HAYDEN, ID 83835-8683
(208) 762-0222
(208) 762-5362
Mailing address
8235 N CORNERSTONE DR, HAYDEN, ID 83835-8683
(208) 762-0222
(208) 762-5362
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
CH00002763
WA
111N00000X
Chiropractor
Primary
CHIA-699
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010024376
REGENCE BLUE SHEILD
ID
05
—
002764300
—
ID
01
—
26526
GROUP HEALTH
—
01
—
350038842
RAILROAD MEDICARE
ID
01
—
37099
LABOR AND INDUSTRIES
WA
01
—
C6996
BLUE CROSS
ID
Enumeration date
01/29/2007
Last updated
01/21/2014
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