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Organization

CLEVERLEY CHIROPRACTIC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MANDY CLEVERLEY (SECRETARY/OFFICE MANAGER)
(208) 543-2005
Entity
Organization

Contact information

Practice address
720 US-30, BUHL, ID 83316
(208) 543-2005
Mailing address
800 MAIN ST, BUHL, ID 83316-1236
(208) 543-2005
(208) 543-4172

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CHIA902
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000010027755
REGENCE BLUE SHIELD
ID
05
805752600
ID
01
C9917
BLUE CROSS OF IDAHO
ID
Enumeration date
01/29/2008
Last updated
12/06/2023
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