Liljenquist, Cody Shawn
Liljenquist, Cody Shawn is an sole proprietor health care provider with primary practice located at 1700 Overland Ave , Burley ID 83318-2436. He recently has only one registered license in Chiropractic Providers / Orthopedic, which is considered as his primary health care specialty. Liljenquist, Cody Shawn can be contacted via phone (208) 678-2631.Contact Information
Primary practice address
1700 Overland Ave
Burley ID 83318-2436
Phone: (208) 678-2631
Fax: (208) 678-2631
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Chiropractic Providers / Orthopedic | 111NX0800X | CHIA577 | Idaho |
Profile Details
| NPI number | 1356409445 |
|---|---|
| LBN Legal business name | Liljenquist, Cody Shawn |
| Credentials | Doctor of Chiropractic (DC) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Dec 4th, 2006 |
| Last updated | Jul 8th, 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1356409445 | NPPES |
| Idaho | MEDICAID | 002663000 |
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