Provider Demographics
NPI:1114280203
Name:INZER, COLBY TODD (ND)
Entity Type:Individual
Prefix:DR
First Name:COLBY
Middle Name:TODD
Last Name:INZER
Suffix:
Gender:M
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1365
Mailing Address - Street 2:
Mailing Address - City:EAGLE
Mailing Address - State:ID
Mailing Address - Zip Code:83616-1365
Mailing Address - Country:US
Mailing Address - Phone:208-995-2891
Mailing Address - Fax:208-995-2891
Practice Address - Street 1:150 AIKENS RD
Practice Address - Street 2:SUITE B
Practice Address - City:EAGLE
Practice Address - State:ID
Practice Address - Zip Code:83616-4900
Practice Address - Country:US
Practice Address - Phone:208-995-2891
Practice Address - Fax:208-995-3891
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-22
Last Update Date:2013-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath