Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 1762 | ID |
N | 111NR0400X | Rehabilitation Chiropractor | 6819 | CO |
NPI | 1114364569 |
---|---|
Provider Name | Dr. Joseph Blampied |
First Address | Boise, ID 83713-0945 |
Second Address | Boise, ID 83713-0945 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/05/2013 |
Last Update Date | 19/04/2017 |