Healthcare Provider Details

I. General information

NPI: 1477467603
Provider Name (Legal Business Name): JOSHUA PAPAC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/02/2026
Last Update Date: 10/02/2026
Certification Date: 10/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13999 W WAINWRIGHT DR STE 201
BOISE ID
83713-1967
US

IV. Provider business mailing address

2363 W PALOUSE ST
BOISE ID
83705-3568
US

V. Phone/Fax

Practice location:
  • Phone: 208-939-0775
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2181210
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: