Doctor Name: | DR. MICHAEL MCCONNELL |
NPI Number: | 1710986518 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | DC |
License Number: | 08001783A |
Business Practice Address: | 16730 N Market Place Blvd Nampa, ID - 836877909 |
Business Phone Number: | 2084664600 |
Business Fax Number: | 2084619236 |
Mailing Address: | 16730 N Market Place Blvd, NAMPA |
State: | ID |
Postal Code: | 836877909 |
Phone Number: | 2084664600 |
Fax Number: | 2084619236 |
NPI Enumeration Date: | 07/14/2005 |
NPI Last Update Date: | 02/17/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 111N00000X |
License Number: | 08001783A |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | IN |
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. |