Provider Demographics
NPI:1295007912
Name:STROH, JOSH GARDNER (DC)
Entity Type:Individual
Prefix:
First Name:JOSH
Middle Name:GARDNER
Last Name:STROH
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 1:1226 E 2 1/2 ST
Mailing Address - Street 2:
Mailing Address - City:MERIDIAN
Mailing Address - State:ID
Mailing Address - Zip Code:83642-1711
Mailing Address - Country:US
Mailing Address - Phone:208-813-6167
Mailing Address - Fax:
Practice Address - Street 1:1226 E 2 1/2 ST
Practice Address - Street 2:
Practice Address - City:MERIDIAN
Practice Address - State:ID
Practice Address - Zip Code:83642-1711
Practice Address - Country:US
Practice Address - Phone:208-813-6167
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-01-27
Last Update Date:2018-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDCHIA-1201111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor