Jeremy J Boethin, DC | |
12545 W Goldcrest St, Star, ID 83669-6513 | |
(541) 480-1555 | |
Not Available |
Full Name | Jeremy J Boethin |
---|---|
Gender | Male |
Speciality | Chiropractic |
Experience | 22 Years |
Location | 12545 W Goldcrest St, Star, Idaho |
Accepts Medicare Assignments | May be. He may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1740314442 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
111N00000X | Chiropractor | 273407 (Oregon) | Secondary |
111N00000X | Chiropractor | CHIA-2246 (Idaho) | Primary |
Provider Name | Elevate Chiropractic |
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Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1457138539 PECOS PAC ID: 5496101867 Enrollment ID: O20231023000798 |
Mailing Address | Practice Location Address |
---|---|
Jeremy J Boethin, DC 12545 W Goldcrest St, Star, ID 83669-6513 Ph: (541) 480-1555 | Jeremy J Boethin, DC 12545 W Goldcrest St, Star, ID 83669-6513 Ph: (541) 480-1555 |
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