Healthcare Provider Details

I. General information

NPI: 1720991771
Provider Name (Legal Business Name): GUILLERMO ZAVALA DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: GIO ZAVALA DC

II. Dates (important events)

Enumeration Date: 09/22/2026
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2167 VILLAGE PARK AVE STE 100
TWIN FALLS ID
83301-4174
US

IV. Provider business mailing address

3239 FALLS AVE E
TWIN FALLS ID
83301-8446
US

V. Phone/Fax

Practice location:
  • Phone: 208-404-5643
  • Fax:
Mailing address:
  • Phone: 208-404-5643
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number7071796
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: