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113 W Main St., Craigmont, ID 83523-0311 | |
(208) 820-4148 | |
Not Available |
Full Name | |
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Type | Facility |
Speciality | Chiropractor - Orthopedic |
Location | 113 W Main St., Craigmont, Idaho |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
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1518030584 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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111NX0800X | Chiropractor - Orthopedic | (* (Not Available)) | Primary |
Provider Name | Loren C Miller |
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Provider Type | Practitioner - Chiropractic |
Provider Identifiers | NPI Number: 1295808343 PECOS PAC ID: 0547254229 Enrollment ID: I20160426000476 |
Mailing Address | Practice Location Address |
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Po Box 311, Craigmont, ID 83523-0311 Ph: (208) 820-4148 | 113 W Main St., Craigmont, ID 83523-0311 Ph: (208) 820-4148 |