Doctor Name: | CORY SHANE LINDSTROM |
NPI Number: | 1265677587 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | D.C. |
License Number: | CHIA-1335 |
Business Practice Address: | 5216 E. Cleveland Blvd Ste G Caldwell, ID - 83607 |
Business Phone Number: | 2084545500 |
Business Fax Number: | 2084548877 |
Mailing Address: | 5216 E. Cleveland Blvd., Ste G CALDWELL |
State: | ID |
Postal Code: | 83607 |
Phone Number: | 2084545500 |
Fax Number: | 2084548877 |
NPI Enumeration Date: | 12/16/2008 |
NPI Last Update Date: | 04/06/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 111N00000X |
License Number: | CHIA-1335 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | ID |
Taxonomy Type: | Chiropractic Providers |
Taxonomy Classification: | Chiropractor |
Taxonomy Specialization: | |
Taxonomy 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 interrelationship with other body systems. |