Provider Demographics
NPI:1194895276
Name:TRAPP, JAMES B (DC)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:B
Last Name:TRAPP
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2419 W STATE ST
Mailing Address - Street 2:SUITE 9
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83702-3120
Mailing Address - Country:US
Mailing Address - Phone:208-389-2225
Mailing Address - Fax:
Practice Address - Street 1:3050 N LAKEHARBOR LN STE 120
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83703-6917
Practice Address - Country:US
Practice Address - Phone:208-389-2225
Practice Address - Fax:208-336-2827
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-08
Last Update Date:2024-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDCHIA882111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID1674773Medicare ID - Type UnspecifiedMEDICARE NUMBER
IDU87455Medicare UPIN