Healthcare Provider Details

I. General information

NPI: 1265654586
Provider Name (Legal Business Name): WILLIAM STEPHEN MIHIN D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/03/2007
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3819 N RHODES AVE
MERIDIAN ID
83646-4190
US

IV. Provider business mailing address

3819 N RHODES AVE
MERIDIAN ID
83646-4190
US

V. Phone/Fax

Practice location:
  • Phone: 208-946-8369
  • Fax:
Mailing address:
  • Phone: 208-946-8369
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCHIA-1235
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: