Ellis, Valden J

Ellis, Valden J is an individual health care provider with primary practice located at 745 W Bridge St Suite F, Blackfoot ID 83221-2000. He recently has only one registered license in Chiropractic Providers / Chiropractor, which is considered as his primary health care specialty. Ellis, Valden J can be contacted via phone (208) 782-9793.

Contact Information

Primary practice address
745 W Bridge St Suite F Blackfoot ID 83221-2000
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Chiropractic Providers / Chiropractor 111N00000X 860 Idaho

Profile Details

NPI number 1689627978
LBN Legal business name Ellis, Valden J
Credentials Doctor of Chiropractic (DC)
Entity Individual
Sole proprietor 1 No
Enumeration date May 18th, 2006
Last updated Jul 9th, 2007 - about 17 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1689627978 NPPES
Idaho Other C8604 BLUE CROSS

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