| Eastern Idaho Chiropractic Clinic Pa | |
|
2585 Channing Way, Idaho Falls, ID 83404-7516 | |
| (208) 522-0200 | |
| (208) 523-6051 |
| Full Name | Eastern Idaho Chiropractic Clinic Pa |
|---|---|
| Type | Facility |
| Speciality | Chiropractor |
| Location | 2585 Channing Way, Idaho Falls, Idaho |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588732523 | NPI | - | NPPES |
| 000010020547 | Other | ID | BLUE SHIELD INSURANCE |
| C9453 | Other | ID | BLUE CROSS INSURANCE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 111N00000X | Chiropractor | (Idaho) | Primary |
| Provider Name | Larry D Nelson |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1518986264 PECOS PAC ID: 9133368889 Enrollment ID: I20130610000659 |
| Mailing Address | Practice Location Address |
|---|---|
| Eastern Idaho Chiropractic Clinic Pa 2585 Channing Way, Idaho Falls, ID 83404-7516 Ph: (208) 522-0200 | Eastern Idaho Chiropractic Clinic Pa 2585 Channing Way, Idaho Falls, ID 83404-7516 Ph: (208) 522-0200 |
Zachary Steven Lovell, DC Chiropractor Medicare: Accepting Medicare Assignments Practice Location: 740 S Woodruff Ave, Idaho Falls, ID 83401 Phone: 208-542-9111 Fax: 208-542-9114 | |
Dr. Rod T. Stocking, D.C. Chiropractor Medicare: Not Enrolled in Medicare Practice Location: 1789 W. Broadway, Idaho Falls, ID 83402 Phone: 208-522-4200 Fax: 208-522-4233 | |
Dr. Freddie L. Sermon, D.C. Chiropractor Medicare: Not Enrolled in Medicare Practice Location: 1880e 17th St, Idaho Falls, ID 83404 Phone: 208-206-0237 | |
William E Clement, DC Chiropractor Medicare: Accepting Medicare Assignments Practice Location: 657 S Woodruff Ave, Idaho Falls, ID 83401 Phone: 208-552-9886 Fax: 208-552-9843 | |
Angela J Sackett, D.C. Chiropractor Medicare: Not Enrolled in Medicare Practice Location: 1278 S Woodruff Ave, Idaho Falls, ID 83404 Phone: 208-528-6010 Fax: 208-528-6011 | |
Bob Phillip Heaton, DC Chiropractor Medicare: Medicare Enrolled Practice Location: 1320 S Ammon Road, Idaho Falls, ID 83406 Phone: 208-529-2084 Fax: 208-529-2084 | |
Dr. Michael Chad Miller, D.C. Chiropractor Medicare: May Accept Medicare Assignments Practice Location: 3419 Merlin Dr, Idaho Falls, ID 83404 Phone: 208-552-8866 Fax: 208-552-8867 |