Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NX0800X | Chiropractor Orthopedic Specialist | CHIA-452 | ID |
NPI | 1699716365 |
---|---|
Provider Name | Dr. David N Price |
First Address | Boise, ID 83704-8103 |
Second Address | Boise, ID 83704-8103 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/06/2006 |
Last Update Date | 09/06/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
CHIA - 452 | CHIROPRACTIC LICENSE (01) | ID |
T44480 | (02) | ID |