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
Fax: (208) 667-2850
Website:

Health care specialties

SpecialtyCodeLicense #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.

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Identifiers

StateTypeNumberIssuer
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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