Coulter Family Chiropractic | |
4619 Emerald St, Ste.102, Boise, ID 83706-2051 | |
(208) 367-1497 | |
(208) 385-9190 |
Full Name | Coulter Family Chiropractic |
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Type | Facility |
Speciality | Chiropractor |
Location | 4619 Emerald St, Boise, Idaho |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1649495532 | NPI | - | NPPES |
805211700 | Medicaid | ID |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
111N00000X | Chiropractor | CHIA798 (Idaho) | Primary |
111N00000X | Chiropractor | CHIA797 (Idaho) | Secondary |
Provider Name | Scott C Coulter |
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Provider Type | Practitioner - Chiropractic |
Provider Identifiers | NPI Number: 1386704708 PECOS PAC ID: 1456401611 Enrollment ID: I20090609000412 |
Provider Name | Theresa M Cramer Coulter |
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Provider Type | Practitioner - Chiropractic |
Provider Identifiers | NPI Number: 1528127453 PECOS PAC ID: 9537496096 Enrollment ID: I20210127001616 |
Mailing Address | Practice Location Address |
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Coulter Family Chiropractic 4619 Emerald St, Ste.102, Boise, ID 83706-2051 Ph: (208) 367-1497 | Coulter Family Chiropractic 4619 Emerald St, Ste.102, Boise, ID 83706-2051 Ph: (208) 367-1497 |
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