Booth, David George
Booth, David George is an individual health care provider with primary practice located at 60 S 2Nd W , Rexburg ID 83440-1819. He recently has only one registered license in Chiropractic Providers / Chiropractor, which is considered as his primary health care specialty. Booth, David George can be contacted via phone (208) 359-2264.Contact Information
Primary practice address
60 S 2Nd W
Rexburg ID 83440-1819
Phone: (208) 359-2264
Fax: (208) 359-0650
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Chiropractic Providers / Chiropractor | 111N00000X | CHIA804 | Idaho |
Profile Details
| NPI number | 1992838601 |
|---|---|
| LBN Legal business name | Booth, David George |
| Credentials | Doctor of Chiropractic (DC) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 13th, 2007 |
| Last updated | Jan 21st, 2020 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1992838601 | NPPES |
| Idaho | Other | C8042 | BLUE CROSS NUMBER |
| Idaho | MEDICAID | 805108000 | BLUE CROSS NUMBER |
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