Forgiven P.a.

NPI #1649495532 in Boise, Idaho

Provider Information

NPI Number: 1649495532
Entity Type: Organization
Organization Name: Forgiven P.a.
Primary Specialty: Chiropractor
Enumeration Date: Apr 16, 2007
Last Updated: May 20, 2009

Practice Location

Address: 4619 EMERALD ST
Address 2: STE.102
City: Boise
State: Idaho
ZIP Code: 83706-2051
Phone: (208) 367-1497

Authorized Official

Name: DR. SCOTT C COULTER, D.C.
Title: DOCTOR
Phone: (208) 367-1497

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Chiropractor	111N00000X	Primary

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