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General NPI Number Information
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NPI Number | 1073056289
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Entity Type | Individual
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Provider Name | NICHOLAS GRABLE DC
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Gender | Male
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Dates
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Enumeration Date | 11/21/2016
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Last Update Date | 07/31/2025
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Provider Practice Location Address
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Address Line | 600 E STATE ST STE 100
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City | EAGLE
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State | ID
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Zip | 83616-6082
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Country | US
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Telephone | 208-939-6748
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Fax |
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Provider Business Mailing Address
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Address Line | 842 E WINDING CREEK DR
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City | EAGLE
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State | ID
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Zip | 83616-7214
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Country | US
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Telephone | 208-481-4705
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Fax | 208-906-1025
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NN1001X
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Taxonomy Name | Nutrition Chiropractor
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License Number | CHIA-1766
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License Number State | ID
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Taxonomy #2
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Taxonomy Code | 175F00000X
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Taxonomy Name | Naturopath
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License Number | 8861663
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License Number State | ID
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