MEDICARE: GUY WILLIAM MCANINCH D.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	CHIA-1266	ID

General Provider Information

NPI Number	:	1205879756
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GUY WILLIAM MCANINCH D.C.

Provider Business Mailing Address
First Line	:	2137 N SYRINGA ST
Second Line	:
City	:	POST FALLS
State	:	ID
Zip	:	83854-4456
Country	:	US
Telephone Number	:	208-773-7304
Fax Number	:	208-773-7304

Provider Business Practice Location Address
First Line	:	2137 N SYRINGA ST
Second Line	:
City	:	POST FALLS
State	:	ID
Zip	:	83854-4456
Country	:	US
Telephone Number	:	208-773-7304
Fax Number	:	208-773-7304

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/13/2006
Last Update Date	:	03/26/2013

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