| Grand Teton Chiropractic, P.c. | |
|
1220 E 17th St, Idaho Falls, ID 83404-6147 | |
| (208) 529-1919 | |
| (208) 552-9447 |
| Full Name | Grand Teton Chiropractic, P.c. |
|---|---|
| Type | Facility |
| Speciality | Chiropractor |
| Location | 1220 E 17th St, 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 |
|---|---|---|---|
| 1679519193 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 111N00000X | Chiropractor | CHIA 904 (Idaho) | Primary |
| Provider Name | James C Gardner |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1821036856 PECOS PAC ID: 2961419262 Enrollment ID: I20060310000627 |
| Mailing Address | Practice Location Address |
|---|---|
| Grand Teton Chiropractic, P.c. 4317 Amber Ln, Ammon, ID 83406-4640 Ph: (208) 542-9567 | Grand Teton Chiropractic, P.c. 1220 E 17th St, Idaho Falls, ID 83404-6147 Ph: (208) 529-1919 |
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 |