Elevate Chiropractic | |
12545 W Goldcrest St, Star, ID 83669-6513 | |
(541) 480-1555 | |
Not Available |
Full Name | Elevate Chiropractic |
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Type | Facility |
Speciality | Chiropractor |
Location | 12545 W Goldcrest St, Star, Idaho |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1457138539 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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111N00000X | Chiropractor | (* (Not Available)) | Primary |
Provider Name | Jeremy Boethin |
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Provider Type | Practitioner - Chiropractic |
Provider Identifiers | NPI Number: 1740314442 PECOS PAC ID: 7214003623 Enrollment ID: I20231023000949 |
Mailing Address | Practice Location Address |
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Elevate Chiropractic 12545 W Goldcrest St, Star, ID 83669-6513 Ph: () - | Elevate Chiropractic 12545 W Goldcrest St, Star, ID 83669-6513 Ph: (541) 480-1555 |
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