Healthcare Provider Details

I. General information

NPI: 1003249608
Provider Name (Legal Business Name): EMILY R WENTWORTH D.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/19/2013
Last Update Date: 12/09/2025
Certification Date: 12/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

609 N CALGARY CT STE 1
POST FALLS ID
83854-4906
US

IV. Provider business mailing address

609 N CALGARY CT STE 1
POST FALLS ID
83854-4906
US

V. Phone/Fax

Practice location:
  • Phone: 208-777-4305
  • Fax: 208-777-4315
Mailing address:
  • Phone: 509-398-1408
  • Fax: 208-777-4315

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCHIA-1637
License Number StateID
# 2
Primary TaxonomyN
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number5771780
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: