Healthcare Provider Details

I. General information

NPI: 1730991894
Provider Name (Legal Business Name): RAUSCH CHIROPRACTIC PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/24/2025
Last Update Date: 01/29/2025
Certification Date: 01/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1390 S MAPLE GROVE RD
BOISE ID
83709-1610
US

IV. Provider business mailing address

1390 S MAPLE GROVE RD
BOISE ID
83709-1610
US

V. Phone/Fax

Practice location:
  • Phone: 208-672-0100
  • Fax: 208-672-0200
Mailing address:
  • Phone: 208-672-0100
  • Fax: 208-672-0200

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DR. JEREMY RAUSCH
Title or Position: OWNER
Credential: DC
Phone: 208-672-0100