Gretchen Michelle Bly in Rexburg - Chiropractor
Gretchen Michelle Bly - NPI 1073630984
Gretchen Michelle Bly is a Chiropractor in Rexburg, Idaho. Gretchen Michelle Bly practices all healthcare services and medical treatments related to Chiropractor. The NPI Number for Gretchen Michelle Bly is 1073630984. The last update date is 2009-08-08.
Gretchen Michelle Bly's current location address is 105 W Main St, Rexburg, Idaho. You can contact this provider via phone number 2083566772. The mailing address for Gretchen Michelle Bly is 105 W Main St, Rexburg, Idaho. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Gretchen Michelle Bly |
|---|---|
| Address | 105 W Main St, Rexburg, Idaho |
| Phone Number | 2083566772 |
| Fax Number | |
| Sole Proprietor | N |
| Credentials | D.C. |
NPI Number Detail
| NPI Number | 1073630984 |
|---|---|
| Provider Enumeration Date | 2007-03-24 |
| Last Updated Date | 2009-08-08 |
Provider Mailing Address Detail
| Address | 105 W Main St |
|---|---|
| City | Rexburg |
| State | Idaho (ID) |
| Post Code | 834402634 |
| Phone Number | 2083566772 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Chiropractor |
|---|---|
| Taxonomy | 111N00000X |
| Licence No | CHIA-1037 |
|
Definition: A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its inte |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 16711661 | ID | MEDICARE GROUP PTAN | |
| 806710900 | ID | -- | |
| 16753471 | ID | MEDICARE PTAN |
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What is the unique provider identifier assigned to Gretchen Michelle Bly?
The Gretchen Michelle Bly has been issued the NPI (National Provider Identifier) 1073630984 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code is a unique identification number for healthcare providers.
Could you please provide the complete physical location address of Gretchen Michelle Bly?
The Gretchen Michelle Bly is physically situated at 105 W Main St, in the city of Rexburg, state of ID, with the postal code 834402634.
What is Gretchen Michelle Bly's specialized area of practice, and what is the corresponding taxonomy classification code for this field?
The Gretchen Michelle Bly's specialized field of practice is Chiropractor, and the corresponding taxonomy code that categorizes this area of specialization is 111N00000X.
On what date did the Centers for Medicare & Medicaid Services assign the 1073630984 to Gretchen Michelle Bly?
The Centers for Medicare & Medicaid Services assigned the 1073630984 to Gretchen Michelle Bly on 2007-03-24.
As of what date were the Gretchen Michelle Bly's details last updated?
The information pertaining to the Gretchen Michelle Bly, including its address, specialty, and other details, was most recently updated on 2009-08-08.