Healthcare Provider Details

I. General information

NPI: 1265365803
Provider Name (Legal Business Name): RUTTER CHIROPRACTIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/04/2026
Last Update Date: 06/04/2026
Certification Date: 06/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1080 W BOISE AVE
BOISE ID
83706-3502
US

IV. Provider business mailing address

1080 W BOISE AVE
BOISE ID
83706-3502
US

V. Phone/Fax

Practice location:
  • Phone: 208-388-1895
  • Fax:
Mailing address:
  • Phone: 208-388-1895
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VIII. Authorized Official

Name: TIM RUTTER
Title or Position: CEO
Credential: DC
Phone: 208-562-9111