Stoddard, Charlene R
Stoddard, Charlene R is an sole proprietor health care provider with primary practice located at 1025 W Ironwood Dr Ste 2, Coeur D Alene ID 83814-3161. She recently has 2 registered licenses in different health care specialties including Chiropractic Providers / Sports Physician, Chiropractic Providers / Chiropractor. Chiropractic Providers / Chiropractor is her primary health care specialty. Stoddard, Charlene R can be contacted via phone (208) 667-0875.Contact Information
Primary practice address
1025 W Ironwood Dr Ste 2
Coeur D Alene ID 83814-3161
Phone: (208) 667-0875
Fax: (208) 667-2850
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Chiropractic Providers / Sports Physician | 111NS0005X | CHIA819 | Idaho |
| Chiropractic Providers / Chiropractor | 111N00000X | CHIA-819 | Idaho |
Profile Details
| NPI number | 1114922739 |
|---|---|
| LBN Legal business name | Stoddard, Charlene R |
| Credentials | Doctor of Chiropractic (DC) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 20th, 2005 |
| Last updated | Jul 12th, 2023 - about last year |
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 | 1114922739 | NPPES |
| Idaho | Other | 000010022440 | BLUE SHIELD |
| Idaho | MEDICAID | 1673575 | BLUE SHIELD |
| Idaho | Other | C-8190 | BLUE SHIELD |
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