MEDICARE: DR. NICHOLAS GRABLE DC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111NN1001X	Nutrition Chiropractor	CHIA-1766	ID
2	175F00000X	Naturopath	8861663	ID

General Provider Information

NPI Number	:	1073056289
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NICHOLAS GRABLE DC

Provider Business Mailing Address
First Line	:	842 E WINDING CREEK DR
Second Line	:
City	:	EAGLE
State	:	ID
Zip	:	83616-7214
Country	:	US
Telephone Number	:	208-481-4705
Fax Number	:	208-906-1025

Provider Business Practice Location Address
First Line	:	600 E STATE ST STE 100
Second Line	:
City	:	EAGLE
State	:	ID
Zip	:	83616-6082
Country	:	US
Telephone Number	:	208-939-6748
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/21/2016
Last Update Date	:	07/31/2025

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