Neville Spinal Balance Pllc | |
2145 West Broadway Street Idaho Falls ID 83402-2904 | |
(208) 522-3130 | |
Not Available |
Full Name | Neville Spinal Balance Pllc |
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Speciality | Clinic/Center |
Location | 2145 West Broadway Street, Idaho Falls, Idaho |
Authorized Official Name and Position | Trever Neville (OWNER) |
Authorized Official Contact | 2085223130 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Neville Spinal Balance Pllc 2145 West Broadway Street Idaho Falls ID 83402-2904 Ph: (208) 522-3130 | Neville Spinal Balance Pllc 2145 West Broadway Street Idaho Falls ID 83402-2904 Ph: (208) 522-3130 |
NPI Number | 1104065093 |
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Provider Enumeration Date | 02/17/2009 |
Last Update Date | 06/05/2020 |
Medicare PECOS PAC ID | 1951467729 |
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Medicare Enrollment ID | O20090303000143 |
Identifier | Type | State | Issuer |
---|---|---|---|
1104065093 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261Q00000X | Clinic/center | CHIA-1331 (Idaho) | Primary |
Provider Name | Trever Neville |
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Provider Type | Practitioner - Chiropractic |
Provider Identifiers | NPI Number: 1700031515 PECOS PAC ID: 6406912278 Enrollment ID: I20090303000136 |
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