MEDICARE: DR. DAMON JOSEF POPOVICS 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	111N00000X	Chiropractor	CHIA1515	ID
2	111N00000X	Chiropractor	28525	CA

General Provider Information

NPI Number	:	1710996533
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAMON JOSEF POPOVICS DC

Provider Business Mailing Address
First Line	:	830 MICHIGAN AVE
Second Line	:
City	:	OROFINO
State	:	ID
Zip	:	83544-7005
Country	:	US
Telephone Number	:	208-476-7091
Fax Number	:	866-993-2828

Provider Business Practice Location Address
First Line	:	830 MICHIGAN AVE
Second Line	:
City	:	OROFINO
State	:	ID
Zip	:	83544-7005
Country	:	US
Telephone Number	:	208-476-7091
Fax Number	:	866-993-2828

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

Provider Enumeration Date	:	08/08/2006
Last Update Date	:	03/27/2019

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Directions to “ DR. DAMON JOSEF POPOVICS DC” Practice Location

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