Grayson Blom D.C.

NPI 1316112428 - Chiropractor - 111N00000X

NPI Details
NPI 1316112428
Gender Male
Enumeration Date 04/29/2008
Last Updated 08/27/2015
Entity Type Individual
Active Over 8 years ago
Practice Location
5975 W. OVERLAND RD.
BOISE ID, 83709, US
Phone (208) 559-0541
Fax
Business Location
5975 W. OVERLAND RD.
BOISE ID, 83709, US
Phone (208) 559-0541
Fax
Toxanomy
Taxonomy Code 111N00000X
License State Idaho
License Number CHIA-1297
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According to our database, Grayson Blom D.C. NPI is 1316112428, taxonomy code is 111N00000X and license number is CHIA-1297, license state is located at Idaho. Grayson Blom D.C. physically located at 5975 W. Overland Rd., Boise ID, 83709. NPI Number Grayson Blom D.C. has the Individual type.

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1316112428 NPI number is provided on an as is basis without warranty of any kind. 1316112428 is maintained by the National Plan & Provider Enumeration System. The contents of Grayson Blom D.C. are for informational purposes only.