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General NPI Number Information
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NPI Number | 1679567564
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Entity Type | Organization
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Legal Business Name | WEAR & ASSOCIATES DC PA
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Dates
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Enumeration Date | 09/07/2005
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Last Update Date | 04/09/2015
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Provider Practice Location Address
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Address Line | 124 12TH AVE RD
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City | NAMPA
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State | ID
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Zip | 83686-5074
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Country | US
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Telephone | 208-466-5459
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Fax | 208-466-5803
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Provider Business Mailing Address
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Address Line | 124 12TH AVE RD
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City | NAMPA
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State | ID
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Zip | 83686-5074
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Country | US
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Telephone | 208-466-5459
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Fax | 208-466-5803
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Authorized Official
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Title or Position | CHIROPRACTOR
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Name | DR. JAMES WILSON WEAR
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Credential | D.C.
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Telephone | 208-466-5459
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | ACC106
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License Number State | ID
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | CHIA276
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License Number State | ID
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