| Ruddell Chiropractic Clinic | |
|
1117 16th Ave, Lewiston, ID 83501-3739 | |
| (208) 743-8401 | |
| (208) 743-8722 |
| Full Name | Ruddell Chiropractic Clinic |
|---|---|
| Type | Facility |
| Speciality | Chiropractor |
| Location | 1117 16th Ave, Lewiston, Idaho |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225235906 | NPI | - | NPPES |
| 805054900 | Medicaid | ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 111N00000X | Chiropractor | CHIA-503 (Idaho) | Primary |
| Provider Name | Brian T Ruddell |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1770648388 PECOS PAC ID: 6103088539 Enrollment ID: I20120510000637 |
| Provider Name | Kevin P Ruddell |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1013072669 PECOS PAC ID: 5597928424 Enrollment ID: I20120512000000 |
| Mailing Address | Practice Location Address |
|---|---|
| Ruddell Chiropractic Clinic 1117 16th Ave, Lewiston, ID 83501-3739 Ph: (208) 743-8401 | Ruddell Chiropractic Clinic 1117 16th Ave, Lewiston, ID 83501-3739 Ph: (208) 743-8401 |
Dr. Kevin Patrick Ruddell, DC Chiropractor Medicare: May Accept Medicare Assignments Practice Location: 1117 16th Avenue, Lewiston, ID 83501 Phone: 208-743-8401 Fax: 208-743-8722 | |
Codi Fuller, D.C. Chiropractor Medicare: Not Enrolled in Medicare Practice Location: 30207 Rosenkrantz Rd, Lewiston, ID 83501 Phone: 208-691-8647 | |
Lewiston Family Chiropractic Chiropractor Medicare: Not Enrolled in Medicare Practice Location: 3510 12th St Ste 200, Lewiston, ID 83501 Phone: 208-799-3333 Fax: 208-799-3375 | |
Dr. Susan Jane Aubuchon, R.N., D.C. Chiropractor Medicare: May Accept Medicare Assignments Practice Location: 3316 1/2 4th St, Ste 4a, Lewiston, ID 83501 Phone: 208-798-5420 Fax: 208-798-5430 | |
Dr. Grover Lynn Mallard, DC Chiropractor Medicare: Not Enrolled in Medicare Practice Location: 3320 10th St, Lewiston, ID 83501 Phone: 208-746-5226 Fax: 208-746-5268 | |
Dr. Thomas Boyer, DC Chiropractor Medicare: Accepting Medicare Assignments Practice Location: 717 D Street, Lewiston, ID 83501 Phone: 208-743-1424 Fax: 208-743-2803 |