| Idaho Chiropractic Group, Pllc | |
|
403 S 11th St, Suite #110, Boise, ID 83702-6968 | |
| (208) 343-6900 | |
| (208) 343-0642 |
| Full Name | Idaho Chiropractic Group, Pllc |
|---|---|
| Type | Facility |
| Speciality | Chiropractor |
| Location | 403 S 11th 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 |
|---|---|---|---|
| 1639280712 | NPI | - | NPPES |
| C1526 | Other | ID | BLUE CROSS |
| 000010027629 | Other | ID | BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 111N00000X | Chiropractor | CHIA-802 (Idaho) | Secondary |
| 111N00000X | Chiropractor | CHIA-559 (Idaho) | Primary |
| Provider Name | Corey D Matthews |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1407958473 PECOS PAC ID: 3072514710 Enrollment ID: I20070124000317 |
| Provider Name | Timothy J Klena |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1174625743 PECOS PAC ID: 1456457985 Enrollment ID: I20070430000612 |
| Provider Name | Nicolas Asla |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1780150292 PECOS PAC ID: 0345580353 Enrollment ID: I20190328001322 |
| Mailing Address | Practice Location Address |
|---|---|
| Idaho Chiropractic Group, Pllc Po Box 7442, Boise, ID 83707-1442 Ph: () - | Idaho Chiropractic Group, Pllc 403 S 11th St, Suite #110, Boise, ID 83702-6968 Ph: (208) 343-6900 |
Johnnie R Clemans, D.C. Chiropractor Medicare: Not Enrolled in Medicare Practice Location: 7805 Ustick Rd, Boise, ID 83704 Phone: 208-375-7851 Fax: 208-375-1905 | |
Dr. Edward Reza Jr., D.C. Chiropractor Medicare: Not Enrolled in Medicare Practice Location: 8631 W Ardene St, Boise, ID 83709 Phone: 208-629-1904 Fax: 208-545-1846 | |
Century Clinic Llc Chiropractor Medicare: Not Enrolled in Medicare Practice Location: 3062 N Five Mile Rd, Suite A, Boise, ID 83713 Phone: 208-377-9500 Fax: 208-377-8449 | |
Healthy Creations Inc Chiropractor Medicare: Medicare Enrolled Practice Location: 2999 N Lakeharbor Ln Ste 201, Boise, ID 83703 Phone: 208-853-2277 Fax: 208-853-2278 | |
Dr. Benjamin Webb, D.C Chiropractor Medicare: Not Enrolled in Medicare Practice Location: 13909 W Wainwright Dr, Boise, ID 83713 Phone: 208-322-7900 | |
Dr. Gary D Musgrave, D.C. Chiropractor Medicare: Not Enrolled in Medicare Practice Location: 3314 N. Cole Rd., Boise, ID 83704 Phone: 208-377-9930 Fax: 208-377-9932 | |
Dr. Luke A. Willett, D.C. Chiropractor Medicare: Not Enrolled in Medicare Practice Location: 3040 N Five Mile Rd, Suite C, Boise, ID 83713 Phone: 208-321-8484 Fax: 208-321-5084 |