Individual
JILLAINE DAWN STMICHEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.C.
Contact information
Practice address
5246 N EAGLE RD, BOISE, ID 83713
(208) 939-3000
Mailing address
5246 N EAGLE RD, BOISE, ID 83713
(208) 939-3000
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CHIA-1661
ID
Other
Enumeration date
12/09/2015
Last updated
12/09/2015
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