Full Name | |
---|---|
Type | Facility |
Speciality | Chiropractor |
Location | 101 E Grove Ave, Parma, Idaho |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1730356361 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
111N00000X | Chiropractor | CHIA857 (Idaho) | Primary |
Provider Name | Shawn A Rudkin |
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Provider Type | Practitioner - Chiropractic |
Provider Identifiers | NPI Number: 1063587194 PECOS PAC ID: 1557392727 Enrollment ID: I20050914000581 |
Mailing Address | Practice Location Address |
---|---|
Po Box 154, Parma, ID 83660-0154 Ph: (208) 722-9999 | 101 E Grove Ave, Parma, ID 83660 Ph: (208) 722-9999 |
Dr. Shawn A Rudkin, DC CCEP Chiropractor Medicare: Accepting Medicare Assignments Practice Location: 101 E Grove Avenue, Parma, ID 83660 Phone: 208-722-9999 |