Provider Demographics
NPI:1073744629
Name:PERRY, WILLIAM EDWARD (DC)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:EDWARD
Last Name:PERRY
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3225 S OXBOW DR
Mailing Address - Street 2:
Mailing Address - City:NAMPA
Mailing Address - State:ID
Mailing Address - Zip Code:83686-4905
Mailing Address - Country:US
Mailing Address - Phone:563-676-7984
Mailing Address - Fax:
Practice Address - Street 1:3225 S OXBOW DR
Practice Address - Street 2:
Practice Address - City:NAMPA
Practice Address - State:ID
Practice Address - Zip Code:83686-4905
Practice Address - Country:US
Practice Address - Phone:563-676-7984
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-30
Last Update Date:2009-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDCHIA-1376111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor