Provider Demographics
NPI:1093379612
Name:REIDINGER, ZACHARY HAAS (DC)
Entity Type:Individual
Prefix:DR
First Name:ZACHARY
Middle Name:HAAS
Last Name:REIDINGER
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 1:3085 E MAGIC VIEW DR STE 180
Mailing Address - Street 2:
Mailing Address - City:MERIDIAN
Mailing Address - State:ID
Mailing Address - Zip Code:83642-3745
Mailing Address - Country:US
Mailing Address - Phone:208-888-6077
Mailing Address - Fax:888-447-1415
Practice Address - Street 1:3085 E MAGIC VIEW DR STE 180
Practice Address - Street 2:
Practice Address - City:MERIDIAN
Practice Address - State:ID
Practice Address - Zip Code:83642-3745
Practice Address - Country:US
Practice Address - Phone:208-888-6077
Practice Address - Fax:888-447-1415
Is Sole Proprietor?:No
Enumeration Date:2019-04-29
Last Update Date:2019-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDCHIA-1927111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor