Provider Demographics
NPI:1699716365
Name:PRICE, DAVID N (DC)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:N
Last Name:PRICE
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 1:9508 FAIRVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83704-8103
Mailing Address - Country:US
Mailing Address - Phone:208-323-1313
Mailing Address - Fax:208-323-1386
Practice Address - Street 1:9508 FAIRVIEW AVE
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83704-8103
Practice Address - Country:US
Practice Address - Phone:208-323-1313
Practice Address - Fax:208-323-1386
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-10
Last Update Date:2014-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDCHIA-452111NX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NX0800XChiropractic ProvidersChiropractorOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
IDCHIA - 452OtherCHIROPRACTIC LICENSE
IDCHIA - 452OtherCHIROPRACTIC LICENSE