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Individual

DR. TIMOTHY LEE PAGE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.C.

Contact information

Practice address
476-1/2 E.CHUBBUCK RD., CHUBBUCK, ID 83202
(208) 478-7243
(208) 237-0712
Mailing address
476-1/2 E.CHUBBUCK RD., CHUBBUCK, ID 83202
(208) 478-7243
(208) 237-0712

Taxonomy

Speciality
Code
Description
License number
State
111NN1001X
Nutrition Chiropractor
Primary
CHIA-974
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
350055267
RAILROAD MEDICARE
ID
Enumeration date
08/02/2005
Last updated
07/05/2011
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