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General NPI Number Information
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NPI Number | 1801695481
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Entity Type | Individual
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Provider Name | LLOLYN POBRAN DC, CHT
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Gender | Female
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Dates
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Enumeration Date | 03/07/2025
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Last Update Date | 03/07/2025
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Provider Practice Location Address
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Address Line | 3895 N SCHREIBER WAY STE 600
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City | COEUR D ALENE
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State | ID
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Zip | 83815-5240
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Country | US
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Telephone | 208-818-3033
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Fax |
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Provider Business Mailing Address
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Address Line | 4473 N MOUNT CARROL ST
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City | COEUR D ALENE
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State | ID
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Zip | 83815-9326
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Country | US
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Telephone | 208-964-3777
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Fax |
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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 | DC11500
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 111NN1001X
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Taxonomy Name | Nutrition Chiropractor
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License Number | DC11500
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License Number State | ID
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Taxonomy #3
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Taxonomy Code | 111NN1001X
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Taxonomy Name | Nutrition Chiropractor
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License Number | DC1150
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License Number State | CA
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